Background of the Invention
[0001] In 1983, the etiological cause of AIDS was determined to be the human immunodeficiency
virus (HIV-1). In 1985, it was reported that the synthetic nucleoside 3'-azido-3'-deoxythymidine
(AZT) inhibited the replication of human immunodeficiency virus. Since then, a number
of other synthetic nucleosides, including 2',3'-dideoxyinosine (DDI), 2',3'-dideoxycytidine
(DDC), 2',3'-dideoxy-2',3'-didehydrothymidine (D4T), ((1
S,4
R)-4-[2-amino-6-(cyclopropylamino)-9H-purin-9-yl]-2- cyclopentene-1-methanol sulfate
(ABC), cis-2-hydroxymethyl-5-(5-fluorocytosin-1-yl)-1,3-oxathiolane ((-)-FTC), and
(-)-cis-2-hydroxymethyl-5-(cytosin-1-yl)-1,3-oxathiolane (3TC), have been proven to
be effective against HIV-1. After cellular phosphorylation to the 5'-triphosphate
by cellular kinases, these synthetic nucleosides are incorporated into a growing strand
of viral DNA, causing chain termination due to the absence of the 3'-hydroxyl group.
They can also inhibit the viral enzyme reverse transcriptase.
[0002] Drug-resistant variants of HIV-1 can emerge after prolonged treatment with an antiviral
agent. Drug resistance most typically occurs by mutation of a gene that encodes for
an enzyme used in viral replication, and most typically in the case of HIV-1, reverse
transcriptase, protease, or DNA polymerase. Recently, it has been demonstrated that
the efficacy of a drug against HIV-1 infection can be prolonged, augmented, or restored
by administering the compound in combination or alternation with a second, and perhaps
third, antiviral compound that induces a different mutation from that caused by the
principle drug. Alternatively, the pharmacokinetics, biodistribution, or other parameter
of the drug can be altered by such combination or alternation therapy. In general,
combination therapy is typically preferred over alternation therapy because it induces
multiple simultaneous pressures on the virus. However, drug resistance can still emerge,
and no effective cure has yet been identified, such that a patient can ultimately
stop treatment.
[0003] Treatment for AIDS using attachment and fusion inhibitors as well as other antiviral
drugs has been somewhat effective. Current clinical treatments for HIV-1 infections
include triple drug combinations called Highly Active Antiretroviral Therapy ("HAART").
HAART typically involves various combinations of nucleoside reverse transcriptase
inhibitors, non-nucleoside reverse transcriptase inhibitors, and HIV-1 protease inhibitors.
In compliant patients, HAART is effective in reducing mortality and progression of
HIV-1 infection to AIDS. However, these multidrug therapies do not eliminate HIV-1
and long-term treatment often results in multidrug resistance. Also, many of these
drugs are highly toxic and/or require complicated dosing schedules that reduce compliance
and limit efficacy. There is, therefore, a continuing need for the development of
additional drugs for the prevention and treatment of HIV-1 infection and AIDS.
[0004] It would be useful to have combination therapy that minimizes the virological failure
of patients taking conventional antiretroviral therapy. It would also be useful to
provide a therapy that can provide a cure for HIV/AIDS, by destroying the virus altogether
in all its reservoirs. The present invention provides such therapy, as well as methods
of treatment using the therapy.
Summary of the Invention
[0005] Antiretroviral JAK inhibitors, compositions including such inhibitors, and methods
for their use in treating viral infections, are provided. Examples of viruses that
can be treated using the compounds described herein include HIV, including HIV-1 and
HIV-2, Flaviviridae viruses, such as HCV and Dengue, and Alphaviruses such as Chikungunya
virus.
[0006] Representative JAK inhibitors include those disclosed in
U.S. Patent No. 7,598,257, an example of which is Ruxolitinib (Jakafi, Incyte), which has the structure shown
below:

[0007] Representative JAK inhibitors also include those disclosed in
U.S. Patent Nos. Re 41,783;
7,842,699;
7,803,805;
7,687,507;
7,601,727;
7,569,569;
7,192,963;
7,091,208;
6,890,929,
6,696,567;
6,962,993;
6,635,762;
6,627,754; and
6,610,847, an example of which is Tofacitinib (Pfizer), which has the structure shown below:

and which has the chemical name 3-{(3R,4R)-4 methyl-3-[methyl-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-amino]-piperidin-1-yl}-3-oxo-propionitrile.
[0008] In one embodiment, the compounds have the formula:

wherein:
or the pharmaceutically acceptable salt thereof; wherein
R
1 is a group of the formula

wherein
y is 0, 1 or 2;
R4 is selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C2-C6)alkenyl, (C2-C6)alkynyl wherein the alkyl, alkenyl and alkynyl groups are optionally substituted
by deuterium, hydroxy, amino, trifluoromethyl, (C1-C4)alkoxy, (C1-C6)acyloxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, nitro, (C2-C6)alkenyl, (C2-C6)alkynyl or (C1-C6)acylamino; or
R4 is (C3-C10)cycloalkyl wherein the cycloalkyl group is optionally substituted by deuterium, hydroxy,
amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R5 is (C2-C9)heterocycloalkyl wherein the heterocycloalkyl groups must be substituted by one to
five carboxy, cyano, amino, deuterium, hydroxy, (C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N-CO-( C1-C6)alkyl, (C1-C6)alkyl-S(O)m, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl; or a group of the formula
wherein a is 0, 1, 2, 3 or 4;
b, c, e, f and g are each independently 0 or 1;
d is 0, 1, 2, or 3;
X is S(O)n wherein n is 0, 1 or 2; oxygen, carbonyl or --C(=N-cyano)-;
Y is S(O)n wherein n is 0, 1 or 2; or carbonyl; and
Z is carbonyl, C(O)O--, C(O)NR-- or S(O)n wherein n is 0, 1 or 2;
R6, R7, R8, R9, R10 and R11 are each independently selected from the group consisting of hydrogen or (C1-C6)alkyl optionally substituted by deuterium, hydroxy, amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R12 is carboxy, cyano, amino, oxo, deuterium, hydroxy, trifluoromethyl, (C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO--( C1-C6)alkyl, R15C(O)NH, R15OC(O)NH, R15NHC(O)NH, (C1-C6)alkyl-S(O)m, (C1-C6)alkyl-S(O)m--( C1-C6)alkyl, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16N(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl;
R2 and R3 are each independently selected from the group consisting of hydrogen, deuterium,
amino, halo, hydroxy, nitro, carboxy, (C2-C6)alkenyl, (C2-C6)alkynyl, trifluoromethyl, trifluoromethoxy, (C1-C6)alkyl, (C1-C6)alkoxy, (C3-C10)cycloalkyl wherein the alkyl, alkoxy or cycloalkyl groups are optionally substituted
by one to three groups selected from halo, hydroxy, carboxy, amino (C1-C6)alkylthio, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl, (C3-C9)cycloalkyl or (C6-C10)aryl; or R2 and R3 are each independently (C3-C10)cycloalkyl, (C3-C10)cycloalkoxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C6-C10)arylamino, (C1-C6)alkylthio, (C6-C10)arylthio, (C1-C6)alkylsulfinyl, (C6-C10)arylsulfinyl, (C1-C6)alkylsulfonyl, (C6-C10)arylsulfonyl, (C1-C6)acyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkylamino-CO--, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl or (C6-C10)aryl wherein the heteroaryl, heterocycloalkyl and aryl groups are optionally substituted
by one to three halo, (C1-C6)alkyl, (C1-C6)alkyl-CO--NH--, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, carboxy(C1-C6)alkoxy, benzyloxycarbonyl(C1-C6)alkoxy, (C1-C6)alkoxycarbonyl(C1-C6)alkoxy, (C6-C10)aryl, amino, amino(C1-C6)alkyl, (C1-C6)alkoxycarbonylamino, (C6-C10)aryl(C1-C6)alkoxycarbonylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C1-C6)alkylamino(C1-C6)alkyl, ((C1-C6)alkyl)2amino(C1-C6)alkyl, hydroxy, (C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, (C1-C6)alkoxycarbonyl, (C1-C6)alkoxycarbonyl(C1-C6)alkyl, (C1-C6)alkoxy-CO-NH--, (C1-C6)alkyl-CO--NH--, cyano, (C5-C9)heterocycloalkyl, amino-CO--NH--, (C1-C6)alkylamino-CO--NH--, ((C1-C6)alkyl)2amino-CO--NH--, (C6-C10)arylamino-CO-NH--, (C5-C9)heteroarylamino-CO--NH--, (C1-C6)alkylamino-CO--NH--(C1-C6)alkyl, ((C1-C6)alkyl)2amino-CO--NH--(C1-C6)alkyl, (C6-C10)arylamino-CO--NH-(C1-C6)alkyl, (C5-C9)heteroarylamino-CO--NH--(C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C6-Cio)arylsulfonyl, (C6-C10)arylsulfonylamino, (C6-C10)arylsulfonylamino(C1-C6)alkyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C5-C9)heteroaryl or (C2-C9)heterocycloalkyl.
[0009] The JAK inhibitors also include compounds of Formula B:

including pharmaceutically acceptable salt forms or prodrugs thereof, wherein:
A1 and A2 are independently selected from C and N;
T, U, and V are independently selected from O, S, N, CR5, and NR6;
wherein the 5-membered ring formed by A1, A2, U, T, and V is aromatic;
X is N or CR4;
Y is C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, (CR11R12)p--(C3-10 cycloalkylene)-(CR11R12)q, (CR11R12)p-(arylene)-(CR11R12)q, (CR11R12)\p--(C1-10 heterocycloalkylene)-(CR11R12)q, (CR11R12)p-(heteroarylene)-(CR11R12)q, (CR11R12)pO(CR11R12)q, (CR11R12)pS(CR11R12)q, (CR11R12)pC(O)(CR11R12)q, (CR11R12)pC(O)NRc(CR11R12)q, (CR11R12)pC(O)O(CR11R12)q, (CR11R12)pOC(O)( CR11R12)q, (CR11R12)pOC(O)NRc(CR11R12)q, (CR11R12)pNRc(CR11R12)q, (CR11R12)pNRcC(O)NRd(CR11R12)q, (CR11R12)pS(O)(CR11R12)q, (CR11R12)pS(O)NRc(CR11R12)q, (CR11R12)pS(O)2(CR11R12)q, or (CR11R12)pS(O)2NRc(CR11R12)q, wherein said C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, cycloalkylene, arylene, heterocycloalkylene, or heteroarylene, is optionally
substituted with 1, 2, or 3 substituents independently selected from -D1-D2-D3-D4;
Z is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, =C--Ri, =N--Ri, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, N2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
wherein when Z is H, n is 1;
or the --(Y)n-Z moiety is taken together with i) A2 to which the moiety is attached, ii) R5 or R6 of either T or V, and iii) the C or N atom to which the R5 or R6 of either T or V is attached to form a 4- to 20-membered aryl, cycloalkyl, heteroaryl,
or heterocycloalkyl ring fused to the 5-membered ring formed by A1 A2, U, T, and V, wherein said 4- to 20-membered aryl, cycloalkyl, heteroaryl, or heterocycloalkyl
ring is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected
from-(W)m-Q;
W is C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, O, S, C(O), C(O)NRc', C(O)O, OC(O), OC(O)NRc', NRc', NRc'C(O)NRd', S(O), S(O)NRc', S(O)2, or S(O)2NRc';
Q is H, halo, CN, NO2, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl, wherein
said C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl is optionally substituted
with 1, 2, 3 or 4 substituents independently selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy2, CN, NO2, ORa', SRa', C(O)Rb', C(O)NRc'Rd', C(O)ORa, OC(O)Rb', OC(O)NRc'Rd', NRc'Rd', NRc'C(O)Rb', NRc'C(O)N Rc'Rd', N Rc'C(O)ORa', S(O)Rb, S(O)N Rc'Rd', S(O)2Rb', NRc'S(O)2Rb', and S(O)2N Rc'Rd';
Cy1 and Cy2 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl,
each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected
from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, CN, NO2, ORa", SRa", C(O)Rb", C(O)NRc''Rd", C(O)ORa", OC(O)Rb", OC(O)N Rc"Rd", NRc"Rd", NRc''C(O)Rb", NRc"C(O)ORa", NRc"S(O)Rb", NRc"S(O)2Rb", S(O)Rb", S(O)NRc"Rd", S(O)2Rb", and S(O)2NRc"Rd";
R1, R2, R3, and R4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NRcC(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, and S(O)2NR9R10;
R5 is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7, OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NR9C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, or S(O)2NR9R10;
R6 is H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, OR7, C(O)R8, C(O)NR9R10, C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, or S(O)2NR9R10;
R7 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R8 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R9 and R10 are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, C1-6 alkylcarbonyl, arylcarbonyl, C1-6 alkylsulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl,
heteroarylalkyl, cycloalkylalkyl and heterocycloalkylalkyl;
or R9 and R10 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group;
R11 and R12 are independently selected from H and -E1-E2-E3-E4;
D1 and E1 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D2 and E2 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, (C1-6 alkylene),--O--(C1-6 alkylene)s, (C1-6 alkylene)r--S--(C1-6 alkylene)s, (C1-6 alkylene),--NR--(C1-6 alkylene)s, (C1-6 alkylene)r--CO--(C1-6 alkylene)s, (C1-6 alkylene)r--COO--(C1-6 alkylene)s, (C1-6 alkylene)r-CONRc--(C1-6 alkylene)s, (C1-6 alkylene)r--SO--(C1-6 alkylene)s, (C1-6 alkylene)r--SO2--(C1-6 alkylene)s, (C1-6 alkylene)r--SONRc--(C1-6 alkylene)s, and (C1-6 alkylene)r-NRcCONRf--(C1-6 alkylene)s, wherein each of the C1-6 alkylene, C2-6 alkenylene, and C2-6 alkynylene is optionally substituted by 1, 2 or 3 substituents independently selected
from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D3 and E3 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
E4 and E4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRa, C(O)ORa, OC(O)RbOC(O)NRcRd NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
Ra is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-61-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ra' and Ra" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb' and Rb" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc and Rd are independently selected from H, Cy1, --(C1-6 alkyl)-Cy1, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl, is optionally substituted with 1, 2, or 3 substituents independently selected
from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
Rc' and Rd' are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
or Rc' and Rd' together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc" and Rd" are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, C1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;
or Rc" and Rd" together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
R1 is H, CN, NO2, or C1-6 alkyl;
Re and Rf are independently selected from H and C1-6 alkyl;
R1 is H, CN, or NO2;
m is 0 or 1;
n is 0 or 1;
p is 0, 1, 2, 3, 4, 5, or 6;
q is 0, 1, 2, 3, 4, 5 or 6;
r is 0 or 1; and
s is 0 or 1.
[0010] Additional JAK inhibitors include CEP-701 (Lestaurtinib, Cephalon Technology), a
JAK 2 FL3 kinase, AZD1480 (Astra Zeneca), a JAK 2 inhibitor, LY3009104/INCB28050 (Eli
Lilly, Incyte), a JAK 1/2 inhibitor, Pacritinib/SB1518 (S*BIO), a JAK 2 inhibitor,
VX-509 (Vertex), a JAK 3 inhibitor, GLPG0634 (Galapagos), a JAK 1 inhibitor, INC424
(Novartis), a JAK inhibitor, R-348 (Rigel), a JAK 3 inhibitor, CYT387 (YM Bioscience),
a JAK1/2 inhibitor, TG 10138, a JAK 2 inhibitor, AEG 3482 (Axon), a JAK inhibitor,
and pharmaceutically-acceptable salts and prodrugs thereof.
[0011] Lestaurtinib has the following formula:

[0012] AEG 3482 has the following formula:

[0013] TG 10138 has the following formula:

[0014] CYT387 has the following formula:

[0015] AZD1480 has the following formula:

[0016] LY3009104 is believed to be (R)-3-(4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl-3-cyclopentyl-propanenitrile
[0017] Pacritinib has the following formula:

[0022] The compounds also include those described in
U.S. Publication No. 20110092499. Representative compounds include:
1. 7-iodo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 2. 7-(4-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine
3. N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acryl- amide
4. 7-(3-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-- amine 5. N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phen-
yl)acrylamide 7. N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 8. methyl 2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxylate
9. N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine 10. 7-(4-amino-3-methoxyphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin--
2-amine 11. 4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonam-
ide 12. N,N-dimethyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-- 7-yl)benzenesulfonamide
13. 1-ethyl-3-(2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin- -7-yl)phenyl)urea
14. N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide
15. 2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)pheno- 1 16.
2-cyano-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)phenyl)acetamide
17. N-(cyanomethyl)-2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carb- oxamide
18. N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide
19. 1-ethyl-3-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)-2-(-trifluoromethoxy)phenyl)urea
20. N-(3-nitrophenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine 21. 7-iodo-N-(3-nitrophenyl)thieno[3,2-d]pyrimidin-2-amine
22. N1-(7-(2-ethylphenyl)thieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine 25. N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be-
nzenesulfonamide 26. N1-(7-iodothieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine 28.
7-(4-amino-3-(tri fluoromethoxy)phenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amin-
e 29. 7-(2-ethylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-ami- ne 30.
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl-)acetamide 31.
N-(cyanomethyl)-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide
32. N-(cyanomethyl)-N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7- -yl)phenyl)methanesulfonamide
33. N-(3-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide
34. 4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide
36. N-(4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-l)phenyl)methanesulfonamide
37. 7-iodo-N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine 38. 7-(2-isopropylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amin-
e 39. 7-bromo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 40. N7-(2-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-
-diamine 41. N7-(4-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-
-diamine 42. 7-(5-amino-2-methylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-
-amine 43. N-(cyanomethyl)-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyri- midin-7-yl)benzamide
44. 7-iodo-N-(3-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 45. 7-(4-amino-3-nitrophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2--
amine 46. 7-(2-methoxypyridin-3-yl)-N-(4-morpholinophenyl)thieno[3,2-d]pyr- imidin-2-amine
47. (3-(7-iodothieno[3,2-d]pyrimidin-2-ylamino)phenyl)methanol 48. N-tert-butyl-3-(2-(3-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide
49. N-tert-butyl-3-(2-(3-(hydroxymethyl)phenylamino)thieno[3,2-d]pyrimidin-7-- yl)benzenesulfonamide
50. N-(4-morpholinophenyl)-7-(4-nitrophenylthio)-5H-pyrrolo[3,2-d]pyrimidin-2- -amine
51. N-tert-butyl-3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyr- imidin-7-yl)benzenesulfonamide
52. 7-(4-amino-3-nitrophenyl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2- -amine
53. N-(3,4-dimethoxyphenyl)-7-(2-methoxypyridin-3-yl)thieno[3,2-d]p- yrimidin-2-amine
54. N-tert-butyl-3-(2-(3,4-dimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide
55. 7-(2-aminopyrimidin-5-yl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2- -amine
56. N-(3,4-dimethoxyphenyl)-7-(2,6-dimethoxypyridin-3-yl)thieno[3,2- -d]pyrimidin-2-amine
57. N-(3,4-dimethoxyphenyl)-7-(2,4-dimethoxypyrimidin-5-yl)thieno[3,2-d]pyrim- idin-2-amine
58. 7-iodo-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine 59. N-tert-butyl-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-
-7-yl)benzenesulfonamide 60. 2-cyano-N-(4-methyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin--
7-yl)phenyl)acetamide 61. ethyl 3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzoate
62. 7-bromo-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-a- mine
63. N-(3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]py- rimidin-7-yl)phenyl)acetamide
64. N-(cyanomethyl)-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)benzamide
65. N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be- nzamide
66. N-tert-butyl-3-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]p- yrimidin-7-yl)benzenesulfonamide
67. tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-pyr-azole-1-carboxylate
68. 7-bromo-N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)thieno[3,2-d]pyrimidin- -2-amine
69. N-tert-butyl-3-(2-(4-((4-ethylpiperazin-1-yl)methyl)phenylamino)thieno[3,- 2-d]pyrimidin-7-yl)benzenesulfonamide
70. N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2- -d]pyrimidin-2-amine
71. N-(cyanomethyl)-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimi- din-7-yl)benzamide
72. N-tert-butyl-3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]- pyrimidin-7-yl)benzenesulfonamide
73. tert-butyl pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate
74. 3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyri- midin-7-yl)benzenesulfonamide
75. 7-(3-chloro-4-fluorophenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno- [3,2-d]pyrimidin-2-amine
76. tert-butyl 4-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl-)-1H-pyrazole-1-carboxylate
77. 7-(benzo[d][1,3]dioxol-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]p- yrimidin-2-amine
78. tert-butyl 5-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-ind-
ole-1-carboxylate 79. 7-(2-aminopyrimidin-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyri-
midin-2-amine 80. tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-5,6-di-
hydropyridine-1(2H)-carboxylate 81. tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate
82. N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)- phenyl)acetamide
83. N-(4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide
84. N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phen- yl)methanesulfonamide
85. 7-(4-(4-methylpiperazin-1-yl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno- [3,2-d]pyrimidin-2-amine
86. N-(2-methoxy-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin- -7-yl)phenyl)acetamide
87. 7-bromo-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine 88. (3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)met-
hanol 89. (4-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)p- henyl)methanol
90. (3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methano- 1 91.
(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)me- thanol 92. N-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7--yl)benzyl)methanesulfonamide
93. tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate
94. N-(4-(morpholinomethyl)phenyl)-7-(3-(piperazin-1-yl)phenyl)thieno[3,2- -d]pyrimidin-2-amine
95. 7-(6-(2-morpholinoethylamino)pyridin-3-yl)-N-(3,4,5-trimethoxyphenyl)thie- no[3,2-d]pyrimidin-2-amine
96. 7-(2-ethylphenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyr- imidin-2-amine
97. 7-(4-(aminomethyl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyri- midin-2-amine
98. N-(4-(1-ethylpiperidin-4-yloxy)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]py-rimidin-2-amine
99. N-(2,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine 100. 7-bromo-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine
101. N-(3,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine
[0024] The present invention also relates to the use of pharmaceutically acceptable acid
addition salts of compounds of Formulas A and B, as well as the additional JAK inhibitors
described herein. The acids which are used to prepare the pharmaceutically acceptable
acid addition salts of the aforementioned base compounds of this invention are those
which form non-toxic acid addition salts, i.e., salts containing pharmacologically
acceptable anions, such as the hydrochloride, hydrobromide, hydroiodide, nitrate,
sulfate, bisulfate, phosphate, acid phosphate, acetate, lactate, citrate, acid citrate,
tartrate, bitartrate, succinate, maleate, fumarate, gluconate, saccharate, benzoate,
methanesulfonate, ethanesulfonate, benzenesulfonate, p-toluenesulfonate and pamoate
[i.e., 1,1'-methylene-bis-(2-hydroxy-3-naphthoate)] salts.
[0025] The invention also relates to the use of base addition salts of Formulas A and B.
The chemical bases that may be used as reagents to prepare pharmaceutically acceptable
base salts of those compounds of Formulas A and B that are acidic in nature are those
that form non-toxic base salts with such compounds. Such non-toxic base salts include,
but are not limited to those derived from such pharmacologically acceptable cations
such as alkali metal cations (e.g., potassium and sodium) and alkaline earth metal
cations (e.g., calcium and magnesium), ammonium or watersoluble amine addition salts
such as N-methylglucamine-(meglumine), and the lower alkanolammonium and other base
salts of pharmaceutically acceptable organic amines.
[0026] The JAK inhibitors described herein include all conformational isomers (e.g., cis
and trans isomers. Those compounds which have asymmetric centers exist in different
enantiomeric and diastereomeric forms. This invention relates to the use of all optical
isomers and stereoisomers of the compounds, and mixtures thereof, and to all pharmaceutical
compositions and methods of treatment that may employ or contain them. In this regard,
the invention includes both the E and Z configurations. The compounds of Formulas
A and B can also exist as tautomers. This invention relates to the use of all such
tautomers and mixtures thereof.
[0027] This invention also encompasses pharmaceutical compositions containing prodrugs of
compounds of the Formulas A and B. This invention also encompasses methods of treating
or preventing viral infections that can be treated or prevented by inhibitors of protein
kinases, such as the enzyme Janus Kinase 1, 2, or 3 comprising administering prodrugs
of compounds of the Formulas A and B. Compounds of Formulas A and B having free amino,
amido, hydroxy or carboxylic groups can be converted into prodrugs. Prodrugs include
compounds wherein an amino acid residue, or a polypeptide chain of two or more (e.g.,
two, three or four) amino acid residues which are covalently joined through peptide
bonds to free amino, hydroxy or carboxylic acid groups of compounds of Formulas A
and B. The amino acid residues include the 20 naturally occurring amino acids commonly
designated by three letter symbols and also include, 4-hydroxyproline, hydroxylysine,
demosine, isodemosine, 3-methylhistidine, norvlin, beta-alanine, gamma-aminobutyric
acid, citrulline, homocysteine, homoserine, ornithine and methioine sulfone. Prodrugs
also include compounds wherein carbonates, carbamates, amides and alkyl esters which
are covalently bonded to the above substituents of Formulas A and B through the carbonyl
carbon prodrug sidechain.
[0028] The JAK inhibitors can be used in combination with additional anti-retroviral agents,
including reverse transcriptase inhibitors, such as nucleoside reverse transcriptase
inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI), non-nucleoside
viral polymerase inhibitors, protease inhibitors, fusion inhibitors, entry inhibitors,
attachment inhibitors, and integrase inhibitors such as raltegravir (Isentress) or
MK-0518, GS-9137 (Elvitegravir, Gilead Sciences), GS-8374 (Gilead Sciences), or GSK-364735.
[0029] In one embodiment, the combinations include, in addition to a JAK inhibitor as described
herein, at least one adenine nucleoside antiviral agent, at least one cytosine nucleoside
antiviral agent, at least one guanine nucleoside antiviral agent, and at least one
thymidine nucleoside antiviral agent. In one aspect of this embodiment, the therapeutic
combinations include, and further include at least one additional agent selected from
reverse transcriptase inhibitors, especially non-nucleoside viral polymerase inhibitors,
protease inhibitors, fusion inhibitors, entry inhibitors, attachment inhibitors, and
integrase inhibitors such as raltegravir (Isentress) or MK-0518, GS-9137 (elvitegravir,
Gilead Sciences), GS-8374 (Gilead Sciences), or GSK-364735.
[0030] Certain JAK inhibitors are also inhibitors of CYP3A4, which means that they will
significantly increase the C
max plasma level of any anti-HIV drug that binds to CYP3A4, including HIV-1 protease
inhibitors.
[0031] It is believed that this therapy, particularly when administered at an early stage
in the development of HIV-1 infection, has the possibility of eliminating HIV-1 infection
in a patient. While not wishing to be bound to a particular theory, it is believed
that the JAK inhibitors function in a way that is not likely to provoke resistance
(i.e., does not involve inhibition of enzymes, or introduction of modified bases in
a way that would provoke enzyme mutations).
[0032] Further, when the JAK inhibitors are combined with different nucleosides containing
all the possible bases (ACTG), optionally in the presence of additional agents, the
combination minimizes the ability of the virus to adapt its reverse transcriptase
and develop resistance to any class of nucleoside antiviral nucleosides (i.e., adenine,
cytosine, thymidine, or guanine), because it would be susceptible to at least one
of the other nucleoside antiviral agents that are present, and/or the additional non-NRTI
therapeutic agent. Furthermore, hitting the same target such as the active site of
the HIV-1 polymerase with different bases allows complete and thorough chain termination
of all the possible growing viral DNA chains. The use of an NNRTI in addition to the
four different nucleosides (ACTG analogs) can be even more effective, since NNRTI
bind to the HIV-polymerase and cause the enzyme to change conformation preventing
chain elogation by natural nucleosides interacting in the active site of the enzyme.
[0033] In any of these embodiments, additional therapeutic agents can be used in combination
with these agents, particularly including agents with a different mode of attack.
Such agents include but are not limited to: antivirals, such as cytokines, e.g., rIFN
alpha, rIFN beta, rIFN gamma; amphotericin B as a lipid-binding molecule with anti-HIV
activity; a specific viral mutagenic agent (e.g., ribavirin), an HIV-1 VIF inhibitor,
and an inhibitor of glycoprotein processing. Representative anti-TNF alpha therapies
include, but are not limited to, Infliximab (Remicade), adalimumab (Humira), certolizumab
pegol (Cimzia), and golimumab (Simponi), alone or with a circulating receptor fusion
protein such as etanercept (Enbrel).
[0034] When administered in combination, the agents can be administered in a single or in
multiple dosage forms. In some embodiments, some of the antiviral agents are orally
administered, whereas other antiviral agents are administered by injection, which
can occur at around the same time, or at different times.
[0035] The compounds can be used in different ways to treat or prevent HIV, and, in one
embodiment, to cure an HIV infection. The invention encompasses combinations of the
two types of antiviral agents, or pharmaceutically acceptable derivatives thereof,
that are synergistic, i.e., better than either agent or therapy alone.
[0036] In one embodiment, a combination of a JAK inhibitor as described herein, a macrophage
depleting agent (e.g., clodronate-loaded liposomes, gadolinium chloride (GdCl)), plus
HAART therapy is used.
[0037] In another embodiment, a combination of a histone deacetylase inhibitor (HDAC inhibitor)
or interleukin 7 (IL-7) and HAART and a JAK inhibitor is used.
[0038] In another embodiment, the JAK inhibitors are administered to a patient before, during,
or after administration of a vaccine or an immunomodulatory agent.
[0039] Combinations of these approaches can also be used.
[0040] The antiviral combinations described herein provide means of treatment which can
not only reduce the effective dose of the individual drugs required for antiviral
activity, thereby reducing toxicity, but can also improve their absolute antiviral
effect, as a result of attacking the virus through multiple mechanisms. That is, various
combinations described herein are useful because their synergistic actions permit
the use of less drug, and/or increase the efficacy of the drugs when used together
in the same amount as when used alone.
[0041] The use of JAK inhibitors, alone or in combination, provides a means for circumventing
the development of viral resistance, thereby providing the clinician with a more efficacious
treatment.
[0042] The disclosed JAK inhibitors, used alone or in combination or in alternation therapies,
are useful in the prevention and treatment of HIV-1 infections and other related conditions
such as AIDS-related complex (ARC), persistent generalized lymphadenopathy (PGL),
AIDS-related neurological conditions, anti-HIV antibody positive and HIV-positive
conditions, Kaposi's sarcoma, thrombocytopenia purpurea and opportunistic infections.
In addition, these compounds or formulations can be used prophylactically to prevent
or retard the progression of clinical illness in individuals who are anti-HIV antibody
or HIV-antigen positive or who have been exposed to HIV. The therapy can be also used
to treat other viral infections, such as HIV-2.
[0043] The invention includes methods for treating or preventing, and uses for the treatment
or prophylaxis, of a
Flaviviridae infection, including all members of the Hepacivirus genus (HCV), Pestivirus genus
(BVDV, CSFV, BDV), or Flavivirus genus (Dengue virus, Japanese encephalitis virus
group (including West Nile Virus), and Yellow Fever virus), as well as Alphaviruses,
such as the Chikungunya virus.
Brief Description of the Figures
[0044]
Figure 1 is a chart showing the potency and toxicity of JAK inhibitors Tofacitinib
or Jakafi versus FDA approved controls AZT and 3TC in acutely infected resting macrophages
(MØ), as well as in peripheral blood mononuclear (PBM) cells. Median effective antiviral
concentration (EC50) data (potency) is shown in terms of µM concentration of the compounds. The IC50 values (toxicity) (µM) are also shown in PBM, MØ cells, CEM cells, and Vero cells.
Figure 2 is a chart showing the effect of various concentrations of Tofacitinib and
Jakafi on cellular proliferation [total cell number (106 cells) versus µM drug] in activated PBM cells incubated for 5 days with the compounds. Cycloheximide
is shown as a positive control, and a "cells plus media" control for each compound
is also shown.
Figure 3 is a chart showing the effect of various concentrations of Tofacitinib and
Jakafi on cellular viability (% viability versus µM drug) in activated PBM cells incubated
for 5 days with the compounds. Cycloheximide is shown as a positive control, and a
"cells plus media" control for each compound is shown as well.
Figures 4a-f show the results of flow cytometric analysis of PHA+IL-2 stimulated primary
human lymphocytes exposed to various concentrations of Jakafi or Tofacitinib for 5
days prior to assessment of viability using propidium iodide (flow cytometry). Histograms
and scatter plots are representative data from at least 3 independent experiments
conducted with pooled cells from 8 donors.
Figure 4a is a scatter plot showing a Side Scatter (SSC) Gating strategy, where the
X-axis in the first chart is Side Scatter Pulse Height (SSC-h) and the Y-axis is Side
Scatter Pulse Width (SSC-w), and in the second chart, the forward-scattered light
(FSC) is shown with the X axis being Forward Scatter Pulse Height (FSC-H) and the
Y axis being Forward Scatter Pulse Width (FSC-W) and Gating strategy based on forward
scatter (FSC) and side scatter (SSC) was established and used uniformly across all
samples (A).
Figure 4B is a histogram showing the results of flow cytometry studies using Propidium
Iodide stain, which is read by the phycoerythrin (PE-A) channel, looking at the cell
counts of viable cells. Propidium iodide is a large molecule, which exclusively intercalates
into the DNA of dead/dying cells and is detectable by PE fluorescence (flow cytometry).
Living cells do not uptake Propidium Iodide, therefore they are not fluorescent or
detectable by the PE channel. Cells incubated in the absence of drug were 92.8 % viable
(therefore 92.8 % of these cells did not uptake the Propidium Iodide stain), and cells
exposed to 95°C heat for 1 minute (positive control for dead cells) were 2.8 % viable
(therefore only 2.8 % of cells were negative for Propidium Iodide stain, whereas 97.2
% were dead, and therefore positive for Propidium Iodide stain) (B). The data is shown
in terms of total percent of cells in each sample, where gating was established based
on viable cells cultured in the absence of drug.
Figure 4c shows histograms comparing the cell viability for cells exposed to Jakafi
and to no drug (i.e., controls) for concentrations of 0.1 µM Jakafi, 1.0 µM Jakafi,
10µM Jakafi, and 50 µM Jakafi.
Figure 4d shows histograms comparing the cell viability for cells exposed to Tofacitinib
and to no drug (i.e., controls) for concentrations of 0.1 µM Tofacitinib, 1.0 µM Tofacitinib,
10µM Tofacitinib, and 50 µM Tofacitinib.
Figures 4e and 4f are charts showing the mean and standard deviations from the experiments
shown in Figures 4c (Jakafi) and 4d (Tofacitinib), respectively.
Figures 5a and 5b are charts showing the percent inhibition of HIV-1 replication versus
untreated control for the co-administration of jakafi and Tofacitinib in primary human
lymphocytes (Figure 5a) and macrophages (Figure 5b). The data is shown in terms of
percent inhibition (%) on the Y axis versus drug concentration (µM) on the X axis.
Figures 6a and 6b are charts showing the fold increase 50 (FI50) and fold increase 90 (FI90) for Jakafi and Tofacitinib against various NRTI-resistant HIV-1 in primary human
lymphocytes. Results with NRTI AZT, (-) FTC, 3TC, D4T, ddI, EFV, and TDF are also
shown.
Figures 7a-7d are charts showing the effect of various Jak inhibitors (Cycloheximide
(black line), Tofacitinib (grey line), and Jakafi (dashed line) on proliferation and
viability of PHA (Figures 7a and 7c) or PHA+IL-2 (Figures 7b and 7d) stimulated primary
human lymphocytes. Figures 7a and 7b are shown in terms of % viable cells versus concentration
of Jak inhibitor (µM). Figures 7c and 7d are shown in terms of cell count (106 cells) versus concentration of Jak inhibitor (µM).
Figures 8a and 8b are charts showing that Tofacitinib and Jakafi inhibit reactivation
of latent HIV-1. Figure 8a shows the results in a primary central memory-based T cell
latency model (Bosque and Planelles (2009) Induction of HIV-1 latency and reactivation in primary
memory CD4+ T cells. Blood 113: 58-65), in terms of the % inhibition of reactivation of latent HIV-1 versus concentration
of Jak inhibitor (µM). Figure 8b shows the results in a J-Lat latency T cell system
(Jordan et al, (2003) HIV reproducibly establishes a latent infection after acute infection
of T cells in vitro. The EMBO Journal, Vol. 22 No. 8 pp. 1868±1877), in terms of the % inhibition of reactivation of latent HIV-1 versus concentration
of Jak inhibitor (µM). Diamonds represent results for Tofacitinib, and squares represent
results for Jakafi.
Figures 9a and 9b are charts showing that Tofacitinib and Jakafi inhibit reactivation
of latent HIV-1 in primary human macrophages. Tofacitinib (Figure 9a) and Jakafi (Figure
9b) inhibit reactivation of latent HIV-1 in primary human macrophages when drug is
applied to cells during reactivation but removed thereafter. Tofacitinib inhibits
∼ 40 % of reactivation while Jakafi inhibits ∼ 35 % of reactivation within 72 hr post
reactivation.
Detailed Description of the Invention
[0045] The present invention is directed to compounds, compositions and methods for treating
viral infections, such as HIV infections, including HIV-1 and HIV-2 infections. In
one embodiment, the compounds are heteroaryl substituted pyrrolo[2,3-b]pyridines and
heteroaryl substituted pyrrolo[2,3-b]pyrimidines that modulate the activity of Janus
kinases (JAK inhibitors).
[0046] The various embodiments of the invention are described in more detail below, and
will be better understood with reference to the following non-limiting definitions.
Definitions:
[0047] Unless defined otherwise, all technical and scientific terms used herein have the
same meaning as is commonly understood by one of ordinary skill in the art. All patents,
applications, published applications and other publications referenced herein are
incorporated by reference in their entirety unless stated otherwise. In the event
that there are a plurality of definitions for a term herein, those in this section
prevail unless stated otherwise.
[0048] As used herein, any "R" group(s) such as, without limitation, R
1, R
1a, R
1b, R
c, and R
1d represent substituents that can be attached to the indicated atom. A non-limiting
list of R groups include, but are not limited to, hydrogen, alkyl, alkenyl, alkynyl,
cycloalkyl, cycloalkenyl, cycloalkynyl, aryl, heteroaryl, heteroalicyclyl, aralkyl,
heteroaralkyl, (heteroalicyclyl)alkyl, hydroxy, protected hydroxy, alkoxy, aryloxy,
acyl, ester, mercapto, cyano, halogen, thiocarbonyl, O-carbamyl, N-carbamyl, O-thiocarbamyl,
N-thiocarbamyl, C-amido, N-amido, S-sulfonamido, N-sulfonamide, C-carboxy, protected
C-carboxy, O-carboxy, isocyanato, thiocyanato, isothiocyanato, nitro, silyl, sulfenyl,
sulfinyl, sulfonyl, haloalkyl, haloalkoxy, trihalomethanesulfonyl, trihalomethanesulfonamido,
and amino, including mono- and di-substituted amino groups, and the protected derivatives
thereof. An R group may be substituted or unsubstituted. If two "R" groups are covalently
bonded to the same atom or to adjacent atoms, then they may be "taken together" as
defined herein to form a cycloalkyl, cycloalkenyl, cycloalkynyl, aryl, heteroaryl
or heteroalicyclyl group. For example, without limitation, if R' and R" of an NR'R"
group are indicated to be "taken together", it means that they are covalently bonded
to one another at their terminal atoms to form a ring that includes the nitrogen:
Whenever a group is described as being "optionally substituted" that group may be
unsubstituted or substituted with one or more of the indicated substituents. Likewise,
when a group is described as being "unsubstituted or substituted" if substituted,
the substituent may be selected from one or more the indicated substituents. If no
substituents are indicated, it is meant that the indicated "optionally substituted"
or "substituted" group may be substituted with one or more group(s) individually and
independently selected from alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, cycloalkynyl,
aryl, heteroaryl, heteroalicyclyl, aralkyl, heteroaralkyl, (heteroalicyclyl)alkyl,
hydroxy, protected hydroxyl, alkoxy, aryloxy, acyl, ester, mercapto, alkylthio, arylthio,
cyano, halogen, thiocarbonyl, O-carbamyl, N-carbamyl, O-thiocarbamyl, N-thiocarbamyl,
C-amido, N-amido, S-sulfonamido, N-sulfonamido, C-carboxy, protected C-carboxy, O-carboxy,
isocyanato, thiocyanato, isothiocyanato, nitro, silyl, sulfenyl, sulfinyl, sulfonyl,
haloalkyl, haloalkoxy, trihalomethanesulfonyl, trihalomethanesulfonamido, and amino,
including mono- and di-substituted amino groups, and the protected derivatives thereof.
Each of these substituents can be further substituted.
[0049] As used herein, "C
a to C
b " in which "a" and "b" are integers refer to the number of carbon atoms in an alkyl,
alkenyl or alkynyl group, or the number of carbon atoms in the ring of a cycloalkyl,
cycloalkenyl, cycloalkynyl, aryl, heteroaryl or heteroalicyclyl group. That is, the
alkyl, alkenyl, alkynyl, ring of the cycloalkyl, ring of the cycloalkenyl, ring of
the cycloalkynyl, ring of the aryl, ring of the heteroaryl or ring of the heteroalicyclyl
can contain from "a" to "b", inclusive, carbon atoms. Thus, for example, a "C
1 to C
4 alkyl" group refers to all alkyl groups having from 1 to 4 carbons, that is, CH
3-, CH
3CH
2-, CH
3CH
2CH
2-, (CH
3)
2CH-, CH
3CH
2CH
2CH
2-, CH
3CH
2CH(CH
3)- and (CH
3)
3C-. If no "a" and "b" are designated with regard to an alkyl, alkenyl, alkynyl, cycloalkyl
cycloalkenyl, cycloalkynyl, aryl, heteroaryl or heteroalicyclyl group, the broadest
range described in these definitions is to be assumed.
[0050] As used herein, the term "alkyl" can be straight or branched hydrocarbon chains that
comprise a fully saturated (no double or triple bonds) hydrocarbon group. The alkyl
group may have 1 to 20 carbon atoms (whenever it appears herein, a numerical range
such as "1 to 20" refers to each integer in the given range; e.g., "1 to 20 carbon
atoms" means that the alkyl group may consist of 1 carbon atom, 2 carbon atoms, 3
carbon atoms, etc., up to and including 20 carbon atoms, although the present definition
also covers the occurrence of the term "alkyl" where no numerical range is designated).
The alkyl group may also be a medium size alkyl having 1 to 10 carbon atoms. The alkyl
group can also be a lower alkyl having 1 to 6 carbon atoms. The alkyl group of the
compounds may be designated as "C
1-C
6 alkyl" or similar designations. By way of example only, "C
1-C
4 alkyl" indicates that there are one to four carbon atoms in the alkyl chain, i.e.,
the alkyl chain is selected from methyl, ethyl, propyl, iso-propyl, n-butyl, iso-butyl,
sec-butyl, and t-butyl. By way of example only, "C
1-C
6 alkyl" indicates that there are one to six carbon atoms in the alkyl chain. Typical
alkyl groups include, but are in no way limited to, methyl, ethyl, propyl, isopropyl,
butyl, isobutyl, tertiary butyl, pentyl, hexyl, and the like. The alkyl group may
be substituted or unsubstituted.
[0051] As used herein, "alkenyl" refers to an alkyl group that contains in the straight
or branched hydrocarbon chain one or more double bonds. An alkenyl group may be unsubstituted
or substituted.
[0052] As used herein, "alkynyl" refers to an alkyl group that contains in the straight
or branched hydrocarbon chain one or more triple bonds. An alkynyl group may be unsubstituted
or substituted.
[0053] As used herein, the term "alkoxy" includes O-alkyl groups wherein "alkyl" is defined
above. As used herein, "cycloalkyl" refers to a completely saturated (no double or
triple bonds) mono- or multi-cyclic hydrocarbon ring system. When composed of two
or more rings, the rings may be joined together in a fused fashion. Cycloalkyl groups
can contain 3 to 10 atoms in the ring(s) or 3 to 8 atoms in the ring(s). A cycloalkyl
group may be unsubstituted or substituted. Typical cycloalkyl groups include, but
are in no way limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, and the
like.
[0054] As used herein, "cycloalkenyl" refers to a mono- or multi-cyclic hydrocarbon ring
system that contains one or more double bonds in at least one ring; although, if there
is more than one, the double bonds cannot form a fully delocalized pi- electron system
throughout all the rings (otherwise the group would be "aryl," as defined herein).
When composed of two or more rings, the rings may be connected together in a fused
fashion. A cycloalkenyl group may be unsubstituted or substituted.
[0055] As used herein, "cycloalkynyl" refers to a mono- or multi-cyclic hydrocarbon ring
system that contains one or more triple bonds in at least one ring. Pf there is more
than one triple bond, the triple bonds cannot form a fully delocalized pi- electron
system throughout all the rings. When composed of two or more rings, the rings may
be joined together in a fused fashion. A cycloalkynyl group may be unsubstituted or
substituted.
[0056] As used herein, "aryl" refers to a carbocyclic (all carbon) monocyclic or multicyclic
aromatic ring system (including fused ring systems where two carbocyclic rings share
a chemical bond) that has a fully delocalized pi-electron system throughout all the
rings. The number of carbon atoms in an aryl group can vary. For example, the aryl
group is a C
6-14 aryl group, a C
6-10 aryl group, or a C
6 aryl group. Examples of aryl groups include, but are not limited to, benzene, naphthalene
and azulene. An aryl group may be substituted or unsubstituted.
[0057] As used herein, "heteroaryl" refers to a monocyclic or multicyclic aromatic ring
system (a ring system with fully delocalized pi-electron system) that contain(s) one
or more heteroatoms, that is, an element other than carbon, including but not limited
to, nitrogen, oxygen and sulfur. The number of atoms in the ring(s) of a heteroaryl
group can vary. For example, the heteroaryl group can contain 4 to 14 atoms in the
ring(s), 5 to 10 atoms in the ring(s) or 5 to 6 atoms in the ring(s). Furthermore,
the term "heteroaryl" includes fused ring systems where two rings, such as at least
one aryl ring and at least one heteroaryl ring, or at least two heteroaryl rings,
share at least one chemical bond. Examples of heteroaryl rings include, but are not
limited to, furan, furazan, thiophene, benzothiophene, phthalazine, pyrrole, oxazole,
benzoxazole, 1,2,3- oxadiazole, 1,2,4-oxadiazole, thiazole, 1,2,3-thiadiazole, 1,2,4-thiadiazole,
benzothiazole, imidazole, benzimidazole, indole, indazole, pyrazole, benzopyrazole,
isoxazole, benzoisoxazole, isothiazole, triazole, benzotriazole, thiadiazole, tetrazole,
pyridine, pyridazine, pyrimidine, pyrazine, purine, pteridine, quinoline, isoquinoline,
quinazoline, quinoxaline, cinnoline, and triazine. A heteroaryl group may be substituted
or unsubstituted.
[0058] As used herein, "heteroalicyclic" or "heteroalicyclyl" refers to three-, four-, five-,
six-, seven-, eight-, nine-, ten-, up to 18-membered monocyclic, bicyclic, and tricyclic
ring system wherein carbon atoms together with from 1 to 5 heteroatoms constitute
said ring system. A heterocycle may optionally contain one or more unsaturated bonds
situated in such a way, however, that a fully delocalized pi-electron system does
not occur throughout all the rings. The heteroatoms are independently selected from
oxygen, sulfur, and nitrogen. A heterocycle may further contain one or more carbonyl
or thiocarbonyl functionalities, so as to make the definition include oxo- systems
and thio-systems such as lactams, lactones, cyclic imides, cyclic thioimides, cyclic
carbamates, and the like. When composed of two or more rings, the rings may be joined
together in a fused fashion. Additionally, any nitrogens in a heteroalicyclic may
be quaternized. Heteroalicyclyl or heteroalicyclic groups may be unsubstituted or
substituted. Examples of such "heteroalicyclic" or "heteroalicyclyl" groups include
but are not limited to, 1,3-dioxin, 1,3-dioxane, 1,4-dioxane, 1,2-dioxolane, 1,3-dioxolane,
1,4-dioxolane, 1,3-oxathiane, 1,4-oxathiin, 1,3-oxathiolane, 1,3-dithiole, 1,3-dithiolane,
1,4-oxathiane, tetrahydro-1,4-thiazine, 2H-1,2-oxazine, maleimide, succinimide, barbituric
acid, thiobarbituric acid, dioxopiperazine, hydantoin, dihydrouracil, trioxane, hexahydro-1,3,5-triazine,
imidazoline, imidazolidine, isoxazoline, isoxazolidine, oxazoline, oxazolidine, oxazolidinone,
thiazoline, thiazolidine, morpholine, oxirane, piperidine N-Oxide, piperidine, piperazine,
pyrrolidine, pyrrolidone, pyrrolidione, A-piperidone, pyrazoline, pyrazolidine, 2-oxopyrrolidine,
tetrahydropyran, 4H-pyran, tetrahydrothiopyran, thiamorpholine, thiamorpholine sulfoxide,
thiamorpholine sulfone, and their benzo-fused analogs (e.g., benzimidazolidinone,
tetrahydroquinoline, 3,4-methylenedioxyphenyl) .
[0059] An "aralkyl" is an aryl group connected, as a substituent, via a lower alkylene group.
The lower alkylene and aryl group of an aralkyl may be substituted or unsubstituted.
Examples include but are not limited to benzyl, substituted benzyl, 2-phenylalkyl,
3-phenylalkyl, and naphtylalkyl.
[0060] A "heteroaralkyl" is heteroaryl group connected, as a substituent, via a lower alkylene
group. The lower alkylene and heteroaryl group of heteroaralkyl may be substituted
or unsubstituted. Examples include but are not limited to 2-thienylalkyl, 3-thienylalkyl,
furylalkyl, thienylalkyl, pyrrolylalkyl, pyridylalkyl, isoxazolylalkyl, and imidazolylalkyl,
and their substituted as well as benzo-fused analogs.
[0061] A "(heteroalicyclyl)alkyl" is a heterocyclic or a heteroalicyclylic group connected,
as a substituent, via a lower alkylene group. The lower alkylene and heterocyclic
or a heterocyclyl of a (heteroalicyclyl)alkyl may be substituted or unsubstituted.
Examples include but are not limited tetrahydro-2H-pyran-4-yl)methyl, (piperidin-4-yl)ethyl,
(piperidin-4-yl)propyl, (tetrahydro-2H-thiopyran-4-yl)methyl, and (1 ,3-thiazinan-4-yl)methyl.
[0062] "Lower alkylene groups" are straight-chained tethering groups, forming bonds to connect
molecular fragments via their terminal carbon atoms. Examples include but are not
limited to methylene (-CH
2-), ethylene (-CH
2CH
2-), propylene (-CH
2CH
2CH
2-), and butylene (-CH
2CH
2CH
2CH
2-). A lower alkylene group may be substituted or unsubstituted.
[0063] As used herein, "alkoxy" refers to the formula -OR wherein R is an alkyl, alkenyl,
alkynyl, cycloalkyl, cycloalkenyl, cycloalkynyl, aryl, heteroaryl, heteroalicyclyl,
aralkyl, or (heteroalicyclyl)alkyl is defined as above. Examples of include methoxy,
ethoxy, n-propoxy, 1-methylethoxy (isopropoxy), n-butoxy, iso-butoxy, sec- butoxy,
tert-butoxy, phenoxy and the like. An alkoxy may be substituted or unsubstituted.
[0064] As used herein, "acyl" refers to a hydrogen, alkyl, alkenyl, alkynyl, or aryl connected,
as substituents, via a carbonyl group. Examples include formyl, acetyl, propanoyl,
benzoyl, and acryl. An acyl may be substituted or unsubstituted.
[0065] As used herein, "hydroxyalkyl" refers to an alkyl group in which one or more of the
hydrogen atoms are replaced by hydroxy group. Examples of hydroxyalkyl groups include
but are not limited to, 2-hydroxyethyl, 3-hydroxypropyl, 2-hydroxypropyl, and 2,2-dihydroxyethyl.
A hydroxyalkyl may be substituted or unsubstituted.
[0066] As used herein, "haloalkyl" refers to an alkyl group in which one or more of the
hydrogen atoms are replaced by halogen (e.g., mono-haloalkyl, di-haloalkyl and tri-haloalkyl).
Such groups include but are not limited to, chloromethyl, fluoromethyl, difluoromethyl,
trifluoromethyl and l-chloro-2-fluoromethyl, 2-fluoroisobutyl. A haloalkyl may be
substituted or unsubstituted.
[0067] As used herein, "haloalkoxy" refers to an alkoxy group in which one or more of the
hydrogen atoms are replaced by halogen (e.g., mono-haloalkoxy, dihaloalkoxy and tri-
haloalkoxy). Such groups include but are not limited to, chloromethoxy, fluoromethoxy,
difluoromethoxy, trifluoromethoxy and 1-chloro-2-fluoromethoxy, 2-fluoroisobutoxy.
A haloalkoxy may be substituted or unsubstituted.
[0068] A "sulfenyl" group refers to an "-SR" group in which R is hydrogen, alkyl, alkenyl,
alkynyl, cycloalkyl, cycloalkenyl, cycloalkynyl, aryl, heteroaryl, heteroalicyclyl,
aralkyl, or (heteroalicyclyl)alkyl. A sulfenyl may be substituted or unsubstituted.
[0069] A "sulfinyl" group refers to an "-S(=O)-R" group in which R is the same as defined
with respect to sulfenyl. A sulfinyl may be substituted or unsubstituted.
[0070] A "sulfonyl" group refers to an "SO
2R" group in which R is the same as defined with respect to sulfenyl. A sulfonyl may
be substituted or unsubstituted.
[0071] An "O-carboxy" group refers to a "RC(=O)O-" group in which R is hydrogen, alkyl,
alkenyl, alkynyl, cycloalkyl, cycloalkenyl, cycloalkynyl, aryl, heteroaryl, heteroalicyclyl,
aralkyl, or (heteroalicyclyl)alkyl, as defined herein. An O-carboxy may be substituted
or unsubstituted.
[0072] The terms "ester" and "C-carboxy" refer to a "-C(=O)OR" group in which R is the same
as defined with respect to O-carboxy. An ester and C-carboxy may be substituted or
unsubstituted.
[0073] A "thiocarbonyl" group refers to a "-C(=S)R" group in which R is the same as defined
with respect to O-carboxy. A thiocarbonyl may be substituted or unsubstituted.
[0074] A "trihalomethanesulfonyl" group refers to an "X
3CSO
2-" group wherein X is a halogen.
[0075] A "trihalomethanesulfonamido" group refers to an "X
3CS(O)
2RN-" group wherein X is a halogen and R defined with respect to O-carboxy.
[0076] The term "amino" as used herein refers to a -NH
2 group.
[0077] As used herein, the term "hydroxy" refers to a -OH group.
[0078] A "cyano" group refers to a "-CN" group.
[0079] The term "azido" as used herein refers to a -N
3 group.
[0080] An "isocyanato" group refers to a "-NCO" group.
[0081] A "thiocyanato" group refers to a "-CNS" group.
[0082] An "isothiocyanato" group refers to an " -NCS" group.
[0083] A "mercapto" group refers to an "-SH" group.
[0084] A "carbonyl" group refers to a C=O group.
[0085] An "S-sulfonamido" group refers to a "-SO
1NR
AR
B" group in which R
A and R
B are the same as R defined with respect to O-carboxy. An S-sulfonamido may be substituted
or unsubstituted.
[0086] An "N-sulfonamido" group refers to a "R
BSO
2N(R
A)-" group in which R
A and R
B are the same as R defined with respect to O-carboxy. A N-sulfonamido may be substituted
or unsubstituted.
[0087] An "O-carbamyl" group refers to a "-OC(=O)NR
AR
B" group in which R
A and R
B are the same as R defined with respect to O-carboxy. An O-carbamyl may be substituted
or unsubstituted.
[0088] An "N-carbamyl" group refers to an "R
BOC(=O)NR
A-" group in which R
A and R
B are the same as R defined with respect to O-carboxy. An N-carbamyl may be substituted
or unsubstituted.
[0089] An "O-thiocarbamyl" group refers to a "-OC(=S)-NR
AR
B" group in which R
A and R
B are the same as R defined with respect to O-carboxy. An O-thiocarbamyl may be substituted
or unsubstituted.
[0090] An "N-thiocarbamyl" group refers to an "R
BOC(=S)NR
A-" group in which R
A and R
B are the same as R defined with respect to O-carboxy. An N-thiocarbamyl may be substituted
or unsubstituted.
[0091] A "C-amido" group refers to a "-C(=O)NR
AR
B" group in which R
A and R
B are the same as R defined with respect to O-carboxy. A C-amido can be substituted
or unsubstituted.
[0092] An "N-amido" group refers to a "R
BC(=O)NR
A-" group in which R
A and R
B are the same as R defined with respect to O-carboxy. An N-amido can be substituted
or unsubstituted.
[0093] As used herein, "organylcarbonyl" refers to a group of the formula -C(=O)R' wherein
R' can be alkyl, alkenyl, alkynyl, cycloalkyl, cycloalkenyl, cycloalkynyl, aryl, heteroaryl,
heteroalicyclyl, aralkyl, or (heteroalicyclyl)alkyl. An organylcarbonyl can be substituted
or unsubstituted.
[0094] The term "alkoxycarbonyl" as used herein refers to a group of the formula - C(=O)OR',wherein
R' is the same as defined with respect to organylcarbonyl. An alkoxycarbonyl can be
substituted or unsubstituted.
[0095] As used herein, "organylaminocarbonyl" refers to a group of the formula C(=O)NR'R"
wherein R' and R" are independently selected from the same substituents as defined
with respect to organylcarbonyl. An organylaminocarbonyl can be substituted or unsubstituted.
[0096] As used herein, the term "levulinoyl" refers to a -C(=O)CH
2CH
2C(=O)CH
3 group.
[0097] The term "halogen atom," as used herein, means any one of the radio- stable atoms
of column 7 of the Periodic Table of the Elements, i.e., fluorine, chlorine, bromine,
or iodine, with fluorine and chlorine being preferred.
[0098] Where the numbers of substituents is not specified (e.g. haloalkyl), there may be
one or more substituents present. For example "haloalkyl" may include one or more
of the same or different halogens. As another example, "C
1-C
3 alkoxyphenyl" may include one or more of the same or different alkoxy groups containing
one, two or three atoms.
[0099] As used herein, the term "nucleoside" refers to a compound composed of any pentose
or modified pentose moiety attached to a specific portion of a heterocyclic base,
tautomer, or derivative thereof such as the 9-position of a purine, 1-position of
a pyrimidine, or an equivalent position of a heterocyclic base derivative. Examples
include, but are not limited to, a ribonucleoside comprising a ribose moiety and a
deoxyribonucleoside comprising a deoxyribose moiety, and in some instances, the nucleoside
is a nucleoside drug analog. As used herein, the term "nucleoside drug analog" refers
to a compound composed of a nucleoside that has therapeutic activity, such as antiviral,
antineoplastic, anti-parasitic and/or antibacterial activity.
[0100] As used herein, the term "nucleotide" refers to a nucleoside having a phosphate ester
substituted on the 5' -position or an equivalent position of a nucleoside derivative.
[0101] As used herein, the term "heterocyclic base" refers to a purine, a pyrimidine and
derivatives thereof. The term "purine" refers to a substituted purine, its tautomers
and analogs thereof. Similarly, the term "pyrimidine" refers to a substituted pyrimidine,
its tautomers and analogs thereof. Examples of purines include, but are not limited
to, purine, adenine, guanine, hypoxanthine, xanthine, theobromine, caffeine, uric
acid and isoguanine. Examples of pyrimidines include, but are not limited to, cytosine,
thymine, uracil, and derivatives thereof. An example of an analog of a purine is 1,2,4-triazole-3-carboxamide.
[0102] Other non-limiting examples of heterocyclic bases include diaminopurine, 8-oxo-N
6 -methyladenine, 7-deazaxanthine, 7-deazaguanine, N
4,N
4-ethanocytosin, N
6,N
6-ethano-2,6-diaminopurine, 5-methylcytosine, 5-fluorouracil, 5-bromouracil, pseudoisocytosine,
isocytosine, isoguanine, and other heterocyclic bases described in
U.S. Patent Nos. 5,432,272 and
7,125,855, which are incorporated herein by reference for the limited purpose of disclosing
additional heterocyclic bases.
[0103] The term "-O-linked amino acid" refers to an amino acid that is attached to the indicated
moiety via its main-chain carboxyl function group. When the amino acid is attached,
the hydrogen that is part of the -OH portion of the carboxyl function group is not
present and the amino acid is attached via the remaining oxygen. An -O-linked amino
acid can be protected at any nitrogen group that is present on the amino acid. For
example, an -O-linked amino acid can contain an amide or a carbamate group. Suitable
amino acid protecting groups include, but are not limited to, carbobenzyloxy (Cbz),
p-methoxybenzyl carbonyl (Moz or MeOZ), tert-butyloxycarbonyl (BOC), 9-fluorenylmethyloxycarbonyl
(FMOC), benzyl (Bn), p-methoxybenzyl (PMB), 3,4-dimethoxybenzyl (DMPM), and tosyl
(Ts) groups. The term "-N-linked amino acid" refers to an amino acid that is attached
to the indicated moiety via its main-chain amino or mono-substituted amino group.
When the amino acid is attached in an -N-linked amino acid, one of the hydrogens that
is part of the main-chain amino or mono-substituted amino group is not present and
the amino acid is attached via the nitrogen. An -N-linked amino acid can be protected
at any hydroxyl or carboxyl group that is present on the amino acid. For example,
an -N-linked amino acid can contain an ester or an ether group. Suitable amino acid
protecting groups include, but are not limited to, methyl esters, ethyl esters, propyl
esters, benzyl esters, tert-butyl esters, silyl esters, orthoesters, and oxazoline.
As used herein, the term "amino acid" refers to any amino acid (both standard and
non- standard amino acids), including, but limited to, α-amino acids β-amino acids,
γ-amino acids and δ- amino acids. Examples of suitable amino acids, include, but are
not limited to, alanine, asparagine, aspartate, cysteine, glutamate, glutamine, glycine,
proline, serine, tyrosine, arginine, histidine, isoleucine, leucine, lysine, methionine,
phenylalanine, threonine, tryptophan and valine.
[0104] The terms "derivative," "variant," or other similar terms refer to a compound that
is an analog of the other compound.
[0105] The terms "protecting group" and "protecting groups" as used herein refer to any
atom or group of atoms that is added to a molecule in order to prevent existing groups
in the molecule from undergoing unwanted chemical reactions. Examples of protecting
group moieties are described in
T. W Greene and P. G. M. Wuts, Protective Groups in Organic Synthesis, 3. Ed. John
Wiley & Sons (1999), and in
J.F.W. McOmie, Protective Groups in Organic Chemistry Plenum Press (1973), both of which are hereby incorporated by reference for the limited purpose of disclosing
suitable protecting groups The protecting group moiety may be chosen in such a way,
that they are stable to certain reaction conditions and readily removed at a convenient
stage using methodology known from the art. A non-limitmg list of protecting groups
include benzyl, substituted benzyl; alkylcarbonyls (e g., t-butoxycarbonyl (BOC));
arylalkylcarbonyls (e.g., benzyloxycarbonyl, benzoyl), substituted methyl ether (e.g.
methoxymethyl ether); substituted ethyl ether, a substituted benzyl ether; tetrahydropyranyl
ether; silyl ethers (e g , tπmethylsilyl, tnethylsilyl, tnisopropylsilyl, t-butyldimethylsilyl,
or t- butyldiphenylsilyl), esters (e.g. benzoate ester), carbonates (e g. methoxymethylcarbonate),
sulfonates (e g tosylate, mesylate), acyclic ketal (e g dimethyl acetal); cyclic ketals
(e.g., 1,3-dioxane or 1,3-dioxolanes); acyclic acetal; cyclic acetal, acyclic hemiacetal,
cyclic hemiacetal, and cyclic dithioketals (e.g., 1,3-dithiane or 1,3-dithiolane).
[0106] "Leaving group" as used herein refers to any atom or moiety that is capable of being
displaced by another atom or moiety in a chemical reaction. More specifically, in
some embodiments, "leaving group" refers to the atom or moiety that is displaced in
a nucleophilic substitution reaction hi some embodiments, "leaving groups" are any
atoms or moieties that are conjugate bases of strong acids Examples of suitable leaving
groups include, but are not limited to, tosylates and halogens Non-limitmg characteristics
and examples of leaving groups can be found, for example in
Organic Chemistry, 2d ed , Francis Carey (1992), pages 328-331,
Introduction to Organic Chemistry, 2d ed., Andrew Streitwieser and Clayton Heathcock
(1981), pages 169-171; and
Organic Chemistry, 5 thed., John McMurry (2000), pages 398 and 408; all of which are incorporated herein by reference for the limited purpose of disclosing
characteristics and examples of leaving groups.
[0107] As used herein, the abbreviations for any protective groups, ammo acids and other
compounds, are, unless indicated otherwise, in accord with their common usage, recognized
abbreviations, or the IUPAC-IUB Commission on Biochemical Nomenclature (See,
Biochem. 1972 11:942-944).
[0108] A "prodrug" refers to an agent that is converted into the parent drug
in vivo. Prodrugs are often useful because, in some situations, they may be easier to administer
than the parent drug. They may, for instance, be bioavailable by oral administration
whereas the parent is not. The prodrug may also have improved solubility in pharmaceutical
compositions over the parent drug. Examples of prodrugs include compounds that have
one or more biologically labile groups attached to the parent drug (e.g., a compound
of Formula I and/or a compound of Formula II). For example, one or more biologically
labile groups can be attached to a functional group of the parent drug (for example,
by attaching one or more biologically labile groups to a phosphate). When more than
one biologically labile groups is attached, the biologically labile groups can be
the same or different. The biologically labile group(s) can be linked (for example,
through a covalent bond), to an oxygen or a heteroatom, such as a phosphorus of a
monophosphate, diphosphate, triphosphate, and/or a stabilized phosphate analog containing
carbon, nitrogen or sulfur (referred to hereinafter in the present paragraph as "phosphate").
In instances where the prodrug is form by attaching one or more biologically labile
groups to the phosphate, removal of the biologically labile group in the host produces
a phosphate. The removal of the biologically labile group(s) that forms the prodrug
can be accomplished by a variety of methods, including, but not limited to, oxidation,
reduction, amination, deamination, hydroxylation, dehydroxylation, hydrolysis, dehydrolysis,
alkylation, dealkylation, acylation, deacylation, phosphorylation, dephosphorylation,
hydration and/or dehydration. An example, without limitation, of a prodrug would be
a compound which is administered as an ester (the "prodrug") to facilitate transmittal
across a cell membrane where water solubility is detrimental to mobility but which
then is metabolically hydrolyzed to the carboxylic acid, the active entity, once inside
the cell where water- solubility is beneficial. A further example of a prodrug might
comprise a short peptide (polyaminoacid) bonded to an acid group where the peptide
is metabolized or cleaved to reveal the active moiety. Additional examples of prodrug
moieties include the following: R*,R*C(=O)OCH
2-, R*C(=O)SCH
2CH
2-, R*C(=O)SCHR'NH-, phenyl-O- , N-linked amino acids, O-linked amino acids, peptides,
carbohydrates, and lipids, wherein each R is independently selected from an alkyl,
an alkenyl, an alkynyl, an aryl, an aralkyl, acyl, sulfonate ester, a lipid, an -N-linked
amino acid, an -O-linked amino acid, a peptide and a cholesterol. The prodrug can
be a carbonate. The carbonate can be a cyclic carbonate. The cyclic carbonate can
contain a carbonyl group between two hydroxyl groups that results in the formation
of a five or six memebered ring. Conventional procedures for the selection and preparation
of suitable prodrug derivatives are described, for example, in
Design of Prodrugs, (ed. H. Bundgaard, Elsevier, 1985), which is hereby incorporated herein by reference for the limited purpose of describing
procedures and preparation of suitable prodrug derivatives.
[0109] The term "pro-drug ester" refers to derivatives of the compounds disclosed herein
formed by the addition of any of several ester-forming groups that are hydrolyzed
under physiological conditions. Examples of pro-drug ester groups include pivaloyloxymethyl,
acetoxymethyl, phthalidyl, indanyl and methoxymethyl, as well as other such groups
known in the art, including a (5-R-2-oxo-1,3-dioxolen-4-yl)methyl group. Other examples
of pro-drug ester groups can be found in, for example,
T. Higuchi and V. Stella, in "Pro-drugs as Novel Delivery Systems", Vol. 14, A.C.S.
Symposium Series, American Chemical Society (1975); and "
Bioreversible Carriers in Drug Design: Theory and Application", edited by E. B. Roche,
Pergamon Press: New York, 14-21 (1987) (providing examples of esters useful as prodrugs for compounds containing carboxyl
groups). Each of the above-mentioned references is herein incorporated by reference
for the limited purpose of disclosing ester-forming groups that can form prodrug esters.
[0110] The term "pharmaceutically acceptable salt" refers to a salt of a compound that does
not cause significant irritation to an organism to which it is administered and does
not abrogate the biological activity and properties of the compound. In some embodiments,
the salt is an acid addition salt of the compound. Pharmaceutical salts can be obtained
by reacting a compound with inorganic acids such as hydrohalic acid (e.g., hydrochloric
acid or hydrobromic acid), sulfuric acid, nitric acid, phosphoric acid and the like.
Pharmaceutical salts can also be obtained by reacting a compound with an organic acid
such as aliphatic or aromatic carboxylic or sulfonic acids, for example acetic, succinic,
lactic, malic, tartaric, citric, ascorbic, nicotinic, methanesulfonic, ethanesulfonic,
p-toluensulfonic, salicylic or naphthalenesulfonic acid. Pharmaceutical salts can
also be obtained by reacting a compound with a base to form a salt such as an ammonium
salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth
metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as
dicyclohexylamine, N-methyl-D-glucamine, tris(hydroxymethyl)methylamine, C
1-C
7 alkylamine, cyclohexylamine, triethanolamine, ethylenediamine, and salts with amino
acids such as arginine, lysine, and the like.
[0111] The term "protected" as used herein and unless otherwise defined refers to a group
that is added to an oxygen, nitrogen, or phosphorus atom to prevent its further reaction
or for other purposes. A wide variety of oxygen and nitrogen protecting groups are
known to those skilled in the art of organic synthesis. The term aryl, as used herein,
and unless otherwise specified, refers to phenyl, biphenyl, or naphthyl, and preferably
phenyl. The aryl group can be optionally substituted with one or more moieties selected
from the group consisting of hydroxyl, amino, alkylamino, arylamino, alkoxy, aryloxy,
nitro, cyano, sulfonic acid, sulfate, phosphonic acid, phosphate, or phosphonate,
either unprotected, or protected as necessary, as known to those skilled in the art,
for example, as taught in
Greene, et al., Protective Groups in Organic Synthesis, John Wiley and Sons, Second
Edition, 1991.
[0112] The term purine or pyrimidine base includes, but is not limited to, adenine, N
6-alkylpurines, N
6-acylpurines (wherein acyl is C(O)(alkyl, aryl, alkylaryl, or arylalkyl), N
6-benzylpurine, N
6-halopurine, N
6-vinylpurine, N
6-acetylenic purine, N
6-acyl purine, N
6-hydroxyalkyl purine, N
6-thioalkyl purine, N
2-alkylpurines, N
2-alkyl-6-thiopurines, thymine, cytosine, 5-fluorocytosine, 5-methylcytosine, 6-azapyrimidine,
including 6-azacytosine, 2- and/or 4-mercaptopyrmidine, uracil, 5-halouracil, including
5-fluorouracil, C
5-alkylpyrimidines, C
5-benzylpyrimidines, C
5-halopyrimidines, C
5-vinylpyrimidine, C
5-acetylenic pyrimidine, C
5-acyl pyrimidine, C
5-hydroxyalkyl purine, C
5-amidopyrimidine, C
5-cyanopyrimidine, C
5-nitropyrimidine, C
5-aminopyrimidine, N
2-alkylpurines, N
2-alkyl-6-thiopurines, 5-azacytidinyl, 5-azauracilyl, triazolopyridinyl, imidazolopyridinyl,
pyrrolopyrimidinyl, and pyrazolopyrimidinyl. Purine bases include, but are not limited
to, guanine, adenine, hypoxanthine, 2,6-diaminopurine, 2-chloro-2-aminopurine, inosine,
and 6-chloropurine. Functional oxygen and nitrogen groups on the base can be protected
as necessary or desired. Suitable protecting groups are well known to those skilled
in the art, and include trimethylsilyl, dimethylhexylsilyl,
t-butyldimethylsilyl, and
t-butyldiphenylsilyl, trityl, alkyl groups, acyl groups such as acetyl and propionyl,
methanesulfonyl, and p-toluenesulfonyl.
[0113] The term acyl refers to a carboxylic acid ester in which the non-carbonyl moiety
of the ester group is selected from straight, branched, or cyclic alkyl or lower alkyl,
alkoxyalkyl including methoxymethyl, aralkyl including benzyl, aryloxyalkyl such as
phenoxymethyl, aryl including phenyl optionally substituted with halogen, C
1 to C
4 alkyl or C
1 to C
4 alkoxy, sulfonate esters such as alkyl or aralkyl sulphonyl including methanesulfonyl,
the mono, di or triphosphate ester, trityl or monomethoxytrityl, substituted benzyl,
trialkylsilyl (e.g. dimethyl-t-butylsilyl) or diphenylmethylsilyl. Aryl groups in
the esters optimally comprise a phenyl group. Acyl can also include a natural or synthetic
amino acid moiety.
[0114] As used herein, the term "substantially free of" or "substantially in the absence
of" refers to a nucleoside composition that includes at least 95% to 98%, or more
preferably, 99% to 100%, of the designated enantiomer of that nucleoside.
[0115] Similarly, the term "isolated" refers to a nucleoside composition that includes at
least 85 or 90% by weight, preferably 95% to 98 % by weight, and even more preferably
99% to 100% by weight, of the nucleoside, the remainder comprising other chemical
species or enantiomers.
[0116] The term "host," as used herein, refers to a unicellular or multicellular organism
in which the virus can replicate, including cell lines and animals, and preferably
a human. Alternatively, the host can be carrying a part of the viral genome, whose
replication or function can be altered by the compounds of the present invention.
The term host specifically refers to infected cells, cells transfected with all or
part of the viral genome and animals, in particular, primates (including chimpanzees)
and humans. Relative to abnormal cellular proliferation, the term "host" refers to
unicellular or multicellular organism in which abnormal cellular proliferation can
be mimicked. The term host specifically refers to cells that abnormally proliferate,
either from natural or unnatural causes (for example, from genetic mutation or genetic
engineering, respectively), and animals, in particular, primates (including chimpanzees)
and humans. In most animal applications of the present invention, the host is a human
patient. Veterinary applications, in certain indications, however, are clearly anticipated
by the present invention (such as bovine viral diarrhea virus in cattle, hog cholera
virus in pigs, and border disease virus in sheep).
[0117] The term "halo", as used herein, unless otherwise indicated, includes fluoro, chloro,
bromo or iodo.
[0118] The compounds of this invention may contain double bonds. When such bonds are present,
the compounds of the invention exist as cis and trans configurations and as mixtures
thereof.
[0119] Unless otherwise indicated, the alkyl and alkenyl groups referred to herein, as well
as the alkyl moieties of other groups referred to herein (e.g., alkoxy), may be linear
or branched, and they may also be cyclic (e.g., cyclopropyl, cyclobutyl, cyclopentyl,
cyclohexyl or cycloheptyl) or be linear or branched and contain cyclic moieties. Unless
otherwise indicated, halogen includes fluorine, chlorine, bromine, and iodine.
[0120] (C
2-C
9)Heterocycloalkyl when used herein refers to pyrrolidinyl, tetrahydrofuranyl, dihydrofuranyl,
tetrahydropyranyl, pyranyl, thiopyranyl, aziridinyl, oxiranyl, methylenedioxyl, chromenyl,
isoxazolidinyl, 1,3-oxazolidin-3-yl, isothiazolidinyl, 1,3-thiazolidin-3-yl, 1,2-pyrazolidin-2-yl,
1,3-pyrazolidin-1-yl, piperidinyl, thiomorpholinyl, 1,2-tetrahydrothiazin-2-yl, 1,3-tetrahydrothiazin-3-yl,
tetrahydrothiadiazinyl, morpholinyl, 1,2-tetrahydrodiazin-2-yl, 1,3-tetrahydrodiazin-1-yl,
tetrahydroazepinyl, piperazinyl, chromanyl, etc. One of ordinary skill in the art
will understand that the connection of said (C
2-C
9)heterocycloalkyl rings is through a carbon or a sp
3 hybridized nitrogen heteroatom.
[0121] (C
2-C
9)Heteroaryl when used herein refers to furyl, thienyl, thiazolyl, pyrazolyl, isothiazolyl,
oxazolyl, isoxazolyl, pyrrolyl, triazolyl, tetrazolyl, imidazolyl, 1,3,5-oxadiazolyl,
1,2,4-oxadiazolyl, 1,2,3-oxadiazolyl, 1,3,5-thiadiazolyl, 1,2,3-thiadiazolyl, 1,2,4-thiadiazolyl,
pyridyl, pyrimidyl, pyrazinyl, pyridazinyl, 1,2,4-triazinyl, 1,2,3-triazinyl, 1,3,5-triazinyl,
pyrazolo[3,4-b]pyridinyl, cinnolinyl, pteridinyl, purinyl, 6,7-dihydro-5H-[1]pyrindinyl,
benzo[b]thiophenyl, 5,6,7,8-tetrahydro-quinolin-3-yl, benzoxazolyl, benzothiazolyl,
benzisothiazolyl, benzisoxazolyl, benzimidazolyl, thianaphthenyl, isothianaphthenyl,
benzofuranyl, isobenzofuranyl, isoindolyl, indolyl, indolizinyl, indazolyl, isoquinolyl,
quinolyl, phthalazinyl, quinoxalinyl, quinazolinyl, benzoxazinyl; etc. One of ordinary
skill in the art will understand that the connection of said (C
2-C
9)heterocycloalkyl rings is through a carbon atom or a sp
3 hybridized nitrogen heteroatom.
[0122] (C
6-C
10)aryl when used herein refers to phenyl or naphthyl.
[0123] As used herein, the term antiviral nucleoside agent refers to antiviral nucleosides
that have anti-HIV activity. The agents can be active against other viral infections
as well, so long as they are active against HIV.
[0124] The term "antiviral thymidine nucleosides" refers to thymidine analogues with anti-HIV
activity, including but not limited to, AZT (zidovudine) and D4T (2',3'-didehydro-3'deoxythymidine
(stravudine), and 1-□-D-Dioxolane)thymine (DOT) or their prodrugs.
[0125] The term "antiviral guanine nucleosides" refers to guanine analogues with anti-HIV
activity, including but not limited to, HBG [9-(4-hydroxybutyl)guanine], lobucavir
([1
R(1alpha,2beta,3alpha)]-9-[2,3-bis(hydroxymethyl)cyclobutyl]guanine), abacavir ((1
S,4
R)-4-[2-amino-6-(cyclopropylamino)-9H-purin-9-yl]-2-cyclopentene-1-methanol sulfate
(salt), a prodrug of a G-carbocyclic nucleoside) and additional antiviral guanine
nucleosides disclosed in
U.S. Patent No. 5,994,321
[0126] The term "antiviral cytosine nucleosides" refers to cytosine analogues with anti-HIV
activity, including but not limited to, (-)-2',3'-dideoxy-3'-thiacytidine (3TC) and
its 5-fluoro analog [(-)-FTC, Emtricitabine], 2',3'-dideoxycytidine (DDC), Racivir,
beta-D-2',3'-didehydro-2',3'-dideoxy-5-fluorocytidine (DFC, D-d4FC, RVT, Dexelvucitabine)
and its enantiomer L-D4FC, and apricitabine (APC, AVX754, BCH-10618).
[0127] The term "antiviral adenine nucleosides" refers to adenine analogues with anti-HIV
activity, including, but not limited to 2',3'-dideoxy-adenosine (ddAdo), 2',3'-dideoxyinosine
(DDI), 9-(2-phosphonylmethoxyethyl)adenine (PMEA), 9-R-2-phosphonomethoxypropyl adenine
(PMPA, Tenofovir) (K65R is resistant to PMPA), Tenofovir disoproxil fumarate (9-[(
R)-2[[bis[[isopropoxycarbonyl)oxy]-methoxy]-phosphinyl]methoxy]propyl]adenine fumarate,
TDF), bis(isopropyloxymethylcarbonyl)PMPA [bis(poc)PMPA], GS-9148 (Gilead Sciences)
as well as those disclosed in
Balzarini, J.; De Clercq, E. Acyclic purine nucleoside phosphonates as retrovirus
inhibitors. In: Jeffries D J, De Clercq E. , editors. Antiviral chemotherapy. New
York, N.Y: John Wiley & Sons, Inc.; 1995. pp. 41-45, the contents of which are hereby incorporated by reference.
[0128] The term AZT is used interchangeably with the term zidovudine throughout. Similarly,
abbreviated and common names for other antiviral agents are used interchangeably throughout.
[0129] As used herein, the term DAPD ((2
R,4
R)-2-amino-9-[(2-hydroxymethyl)-I, 3-dioxolan-4-yl]adenine) is also intended to include
a related form of DAPD known as APD [(-)-β-D-2-aminopurine dioxolane], as well as
all optically active forms of DAPD, including optically active forms and racemic forms
and its phosphate prodrugs as well as dioxolane-G and the 6-methoxy or 6-chloro derivatives.
[0130] As used herein, the term "pharmaceutically acceptable salts" refers to pharmaceutically
acceptable salts which, upon administration to the recipient, are capable of providing
directly or indirectly, a nucleoside antiviral agent, or that exhibit activity themselves.
[0131] As used herein, the term "prodrug," in connection with nucleoside antiviral agents,
refers to the 5' and N-acylated, alkylated, or phosphorylated (including mono, di,
and triphosphate esters as well as stabilized phosphates and phospholipid) derivatives
of nucleoside antiviral agents. In one embodiment, the acyl group is a carboxylic
acid ester in which the non-carbonyl moiety of the ester group is selected from straight,
branched, or cyclic alkyl, alkoxyalkyl including methoxymethyl, aralkyl including
benzyl, aryloxyalkyl including phenoxymethyl, aryl including phenyl optionally substituted
by halogen, alkyl, alkyl or alkoxy, sulfonate esters such as alkyl or aralkyl sulphonyl
including methanesulfonyl, trityl or monomethoxytrityl, substituted benzyl, trialkylsilyl,
or diphenylmethylsilyl. Aryl groups in the esters optimally comprise a phenyl group.
The alkyl group can be straight, branched or cyclic and is preferably C
1-18.
[0132] As used herein, the term "resistant virus" refers to a virus that exhibits a three,
and more typically, five or greater fold increase in EC
50 compared to naive virus in a constant cell line, including, but not limited to peripheral
blood mononuclear (PBM) cells, or MT2 or MT4 cells.
[0133] As used herein, the term "substantially pure" or "substantially in the form of one
optical isomer" refers to a composition that includes at least 95% to 98%, or more,
preferably 99% to 100%, of a single enantiomer of the JAK inhibitors described herein,
and, optionally, to similar concentrations of a single enantiomer of a nucleoside.
In a preferred embodiment, the JAK inhibitors are administered in substantially pure
form.
I. JAK Inhibitors
[0134] Representative JAK inhibitors include those disclosed in
U.S. Patent No. 7,598,257, an example of which is Ruxolitinib (Jakafi, Incyte), which has the structure shown
below:

[0135] Representative JAK inhibitors also include those disclosed in
U.S. Patent Nos. Re 41,783;
7,842,699;
7,803,805;
7,687,507;
7,601,727;
7,569,569;
7,192,963;
7,091,208;
6,890,929,
6,696,567;
6,962,993;
6,635,762;
6,627,754; and
6,610,847, an example of which is Tofacitinib, which has the structure shown below:

[0136] Tofacitinib (Pfizer), and which has the chemical name 3-{(3R,4R)-4 methyl-3-[methyl-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-amino]-piperidin-1-yl}-3-oxo-propionitrile.
[0137] In one embodiment, the compounds have the formula:

wherein:
or the pharmaceutically acceptable salt or prodrug thereof; wherein
R
1 is a group of the formula

wherein
y is 0, 1 or 2;
R4 is selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C2-C6)alkenyl, (C2-C6)alkynyl wherein the alkyl, alkenyl and alkynyl groups are optionally substituted
by deuterium, hydroxy, amino, trifluoromethyl, (C1-C4)alkoxy, (C1-C6)acyloxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, nitro, (C2-C6)alkenyl, (C2-C6)alkynyl or (C1-C6)acylamino; or
R4 is (C3-C10)cycloalkyl wherein the cycloalkyl group is optionally substituted by deuterium, hydroxy,
amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R5 is (C2-C9)heterocycloalkyl wherein the heterocycloalkyl groups must be substituted by one to
five carboxy, cyano, amino, deuterium, hydroxy, (C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)zamino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO--( C1-C6)alkyl, (C1-C6)alkyl-S(O)m, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl; or a group of the formula

wherein
a is 0, 1, 2, 3 or 4;
b, c, e, f and g are each independently 0 or 1;
d is 0, 1, 2, or 3;
X is S(O)n wherein n is 0, 1 or 2; oxygen, carbonyl or --C(=N-cyano)-;
Y is S(O)n wherein n is 0, 1 or 2; or carbonyl; and
Z is carbonyl, C(O)O--, C(O)NR-- or S(O)n wherein n is 0, 1 or 2;
R6, R7, R8, R9, R10 and R11 are each independently selected from the group consisting of hydrogen or (C1-C6)alkyl optionally substituted by deuterium, hydroxy, amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R12 is carboxy, cyano, amino, oxo, deuterium, hydroxy, trifluoromethyl, (C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO--( C1-C6)alkyl, R15C(O)NH, R15OC(O)NH, R15NHC(O)NH, (C1-C6)alkyl-S(O)m, (C1-C6)alkyl-S(O)m--( C1-C6)alkyl, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16N(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl;
R2 and R3 are each independently selected from the group consisting of hydrogen, deuterium,
amino, halo, hydroxy, nitro, carboxy, (C2-C6)alkenyl, (C2-C6)alkynyl, trifluoromethyl, trifluoromethoxy, (C1-C6)alkyl, (C1-C6)alkoxy, (C3-C10)cycloalkyl wherein the alkyl, alkoxy or cycloalkyl groups are optionally substituted
by one to three groups selected from halo, hydroxy, carboxy, amino (C1-C6)alkylthio, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl, (C3-C9)cycloalkyl or (C6-C10)aryl; or R2 and R3 are each independently (C3-C10)cycloalkyl, (C3-C10)cycloalkoxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C6-C10)arylamino, (C1-C6)alkylthio, (C6-C10)arylthio, (C1-C6)alkylsulfinyl, (C6-C10)arylsulfinyl, (C1-C6)alkylsulfonyl, (C6-C10)arylsulfonyl, (C1-C6)acyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkylamino-CO--, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl or (C6-C10)aryl wherein the heteroaryl, heterocycloalkyl and aryl groups are optionally substituted
by one to three halo, (C1-C6)alkyl, (C1-C6)alkyl-CO--NH--, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--( C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, carboxy(C1-C6)alkoxy, benzyloxycarbonyl(C1-C6)alkoxy, (C1-C6)alkoxycarbonyl(C1-C6)alkoxy, (C6-C10)aryl, amino, amino(C1-C6)alkyl, (C1-C6)alkoxycarbonylamino, (C6-C10)aryl(C1-C6)alkoxycarbonylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C1-C6)alkylamino(C1-C6)alkyl, ((C1-C6)alkyl)2amino(C1-C6)alkyl, hydroxy, (C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, (C1-C6)alkoxycarbonyl, (C1-C6)alkoxycarbonyl(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--, cyano, (C5-C9)heterocycloalkyl, amino-CO--NH--, (C1-C6)alkylamino-CO--NH--, ((C1-C6)alkyl)2amino-CO--NH--, (C6-C10)arylamino-CO-NH--, (C5-C9)heteroarylamino-CO--NH--, (C1-C6)alkylamino-CO--NH--( C1-C6)alkyl, ((C1-C6)alkyl)zamino-CO--NH--( C1-C6)alkyl, (C6-C10)arylamino-CO--NH-( C1-C6)alkyl, (C5-C9)heteroarylamino-CO--NH--( C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C6-Cio)arylsulfonyl, (C6-C10)arylsulfonylamino, (C6-C10)arylsulfonylamino(C1-C6)alkyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C5-C9)heteroaryl or (C2-C9)heterocycloalkyl.
[0138] The JAK inhibitors also include compounds of Formula B:

including pharmaceutically acceptable salt forms or prodrugs thereof, wherein:
A1 and A2 are independently selected from C and N;
T, U, and V are independently selected from O, S, N, CR5, and NR6;
wherein the 5-membered ring formed by A1, A2, U, T, and V is aromatic;
X is N or CR4;
Y is C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, (CR11R12)p--(C3-10 cycloalkylene)-(CR11R12)q, (CR11R12)p-(arylene)-(CR11R12)q, (CR11R12)\p--(C1-10 heterocycloalkylene)-(CR11R12)q, (CR11R12)p-(heteroarylene)-(CR11R12)q, (CR11R12)pO(CR11R12)q, (CR11R12)pS(CR11R12)q, (CR11R12)pC(O)(CR11R12)q, (CR11R12)pC(O)NRc(CR11R12)q, (CR11R12)pC(O)O(CR11R12)q, (CR11R12)pOC(O)( CR11R12)q, (CR11R12)pOC(O)NRc(CR11R12)q, (CR11R12)pNRc(CR11R12)q, (CR11R12)pNRcC(O)NRd(CR11R12)q, (CR11R12)pS(O)(CR11R12)q, (CR11R12)pS(O)NRc(CR11R12)q, (CR11R12)pS(O)2(CR11R12)q, or (CR11R12)pS(O)2NRc(CR11R12)q, wherein said C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, cycloalkylene, arylene, heterocycloalkylene, or heteroarylene, is optionally
substituted with 1, 2, or 3 substituents independently selected from -D1-D2-D3-D4;
Z is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, =C--Ri, =N--Ri, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, N2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
wherein when Z is H, n is 1;
or the --(Y)n-Z moiety is taken together with i) A2 to which the moiety is attached, ii) R5 or R6 of either T or V, and iii) the C or N atom to which the R5 or R6 of either T or V is attached to form a 4- to 20-membered aryl, cycloalkyl, heteroaryl,
or heterocycloalkyl ring fused to the 5-membered ring formed by A1 A2, U, T, and V, wherein said 4- to 20-membered aryl, cycloalkyl, heteroaryl, or heterocycloalkyl
ring is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected
from-(W)m-Q;
W is C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, O, S, C(O), C(O)NRc', C(O)O, OC(O), OC(O)NRc', NRc', NRc'C(O)NRd', S(O), S(O)NRc', S(O)2, or S(O)2NRc';
Q is H, halo, CN, NO2, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl, wherein
said C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl is optionally substituted
with 1, 2, 3 or 4 substituents independently selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy2, CN, NO2, ORa', SRa', C(O)Rb', C(O)NRc'Rd', C(O)ORa, OC(O)Rb', OC(O)NRc'Rd', NRc'Rd', NRc'C(O)Rb', NRc'C(O)N Rc'Rd', N Rc'C(O)ORa', S(O)Rb', S(O)N Rc'Rd', S(O)2Rb', NRc'S(O)2Rb', and S(O)2N Rc'Rd';
Cy1 and Cy2 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl,
each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected
from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, CN, NO2, ORa", SRa", C(O)Rb", C(O)NRc''Rd", C(O)ORa", OC(O)Rb", OC(O)N Rc''Rd", NRc''Rd", NRc''C(O)Rb", NRc"C(O)ORa", NRc"S(O)Rb", NRc"S(O)2Rb", S(O)Rb", S(O)NRc"Rd", S(O)2Rb", and S(O)2NRc"Rd";
R1, R2, R3, and R4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NRcC(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, and S(O)2NR9R10;
R5 is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7, OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NR9C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, or S(O)2NR9R10;
R6 is H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, OR7, C(O)R8, C(O)NR9R10, C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, or S(O)2NR9R10;
R7 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R8 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R9 and R10 are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, C1-6 alkylcarbonyl, arylcarbonyl, C1-6 alkylsulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl,
heteroarylalkyl, cycloalkylalkyl and heterocycloalkylalkyl;
or R9 and R10 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group;
R11 and R12 are independently selected from H and -E1-E2-E3-E4;
D1 and E1 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D2 and E2 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, (C1-6 alkylene)r--O--(C1-6 alkylene)s, (C1-6 alkylene)r--S--(C1-6 alkylene)s, (C1-6 alkylene)r--NRc--(C1-6 alkylene)s, (C1-6 alkylene)r--CO--(C1-6 alkylene)s, (C1-6 alkylene)r--COO--(C1-6 alkylene)s, (C1-6 alkylene)r-CONRc--(C1-6 alkylene)s, (C1-6 alkylene)r--SO--(C1-6 alkylene)s, (C1-6 alkylene)r--SO2--(C1-6 alkylene)s, (C1-6 alkylene)r--SONRc--(C1-6 alkylene)s, and (C1-6 alkylene)r-NRcCONRf--(C1-6 alkylene)s, wherein each of the C1-6 alkylene, C2-6 alkenylene, and C2-6 alkynylene is optionally substituted by 1, 2 or 3 substituents independently selected
from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D3 and E3 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
E4 and E4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRa, C(O)ORa, OC(O)RbOC(O)NRcRd NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
Ra is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-61-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ra' and Ra" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb' and Rb" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc and Rd are independently selected from H, Cy1, --(C1-6 alkyl)-Cy1, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl, is optionally substituted with 1, 2, or 3 substituents independently selected
from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
Rc' and Rd' are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
or Rc' and Rd' together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc" and Rd" are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, C1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;
or Rc" and Rd" together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ri is H, CN, NO2, or C1-6 alkyl;
Re and Rf are independently selected from H and C1-6 alkyl;
Ri is H, CN, or NO2;
m is 0 or 1;
n is 0 or 1;
p is 0, 1, 2, 3, 4, 5, or 6;
q is 0, 1, 2, 3, 4, 5 or 6;
r is 0 or 1; and
s is 0 or 1.
[0139] Additional JAK inhibitors include CEP-701 (Lestaurtinib, Cephalon Technology), a
JAK 2 FL3 kinase, AZD1480 (Astra Zeneca), a JAK 2 inhibitor, LY3009104/INCB28050 (Eli
Lilly, Incyte), a JAK 1/2 inhibitor, Pacritinib/SB1518 (S*BIO), a JAK 2 inhibitor,
VX-509 (Vertex), a JAK 3 inhibitor, GLPG0634 (Galapagos), a JAK 1 inhibitor, INC424
(Novartis), a JAK inhibitor, R-348 (Rigel), a JAK 3 inhibitor, CYT387 (YM Bioscience),
a JAK1/2 inhibitor, TG 10138, a JAK 2 inhibitor, AEG 3482 (Axon), a JAK inhibitor,
and pharmaceutically-acceptable salts and prodrugs thereof.
[0140] Lestaurtinib has the following formula:

[0141] AEG 3482 has the following formula:

[0142] TG 10138 has the following formula:

[0143] CYT387 has the following formula:

[0144] AZD1480 has the following formula:

[0145] LY3009104 is believed to be (R)-3-(4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)-1H-pyrazol-1-yl-3-cyclopentyl-propanenitrile
[0146] Pacritinib has the following formula:

[0151] The compounds also include those described in
U.S. Publication No. 20110092499. Representative compounds include:
1. 7-iodo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 2. 7-(4-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine
3. N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acryl- amide
4. 7-(3-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-- amine 5. N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phen-
yl)acrylamide 7. N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 8. methyl 2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxylate
9. N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine 10. 7-(4-amino-3-methoxyphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin--
2-amine 11. 4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonam-
ide 12. N,N-dimethyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-- 7-yl)benzenesulfonamide
13. 1-ethyl-3-(2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin- -7-yl)phenyl)urea
14. N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide
15. 2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)pheno- 1 16.
2-cyano-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)phenyl)acetamide
17. N-(cyanomethyl)-2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carb- oxamide
18. N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide
19. 1-ethyl-3-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)-2-(-trifluoromethoxy)phenyl)urea
20. N-(3-nitrophenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine 21. 7-iodo-N-(3-nitrophenyl)thieno[3,2-d]pyrimidin-2-amine
22. N1-(7-(2-ethylphenyl)thieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine 25. N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be-
nzenesulfonamide 26. N1-(7-iodothieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine 28.
7-(4-amino-3-(tri fluoromethoxy)phenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amin-
e 29. 7-(2-ethylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-ami- ne 30.
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl- )acetamide 31.
N-(cyanomethyl)-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7- - yl)phenyl)methanesulfonamide
32. N-(cyanomethyl)-N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7- -yl)phenyl)methanesulfonamide
33. N-(3-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-1)phenyl)methanesulfonamide
34. 4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide
36. N-(4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-1)phenyl)methanesulfonamide
37. 7-iodo-N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine 38. 7-(2-isopropylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amin-
e 39. 7-bromo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 40. N7-(2-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-
-diamine 41. N7-(4-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-
-diamine 42. 7-(5-amino-2-methylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-
-amine 43. N-(cyanomethyl)-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyri- midin-7-yl)benzamide
44. 7-iodo-N-(3-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 45. 7-(4-amino-3-nitrophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2--
amine 46. 7-(2-methoxypyridin-3-yl)-N-(4-morpholinophenyl)thieno[3,2-d]pyr- imidin-2-amine
47. (3-(7-iodothieno[3,2-d]pyrimidin-2-ylamino)phenyl)methanol 48. N-tert-butyl-3-(2-(3-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide
49. N-tert-butyl-3-(2-(3-(hydroxymethyl)phenylamino)thieno[3,2-d]pyrimidin-7-- yl)benzenesulfonamide
50. N-(4-morpholinophenyl)-7-(4-nitrophenylthio)-5H-pyrrolo[3,2-d]pyrimidin-2- -amine
51. N-tert-butyl-3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyr- imidin-7-yl)benzenesulfonamide
52. 7-(4-amino-3-nitrophenyl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2- -amine
53. N-(3,4-dimethoxyphenyl)-7-(2-methoxypyridin-3-yl)thieno[3,2-d]p- yrimidin-2-amine
54. N-tert-butyl-3-(2-(3,4-dimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide
55. 7-(2-aminopyrimidin-5-yl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2- -amine
56. N-(3,4-dimethoxyphenyl)-7-(2,6-dimethoxypyridin-3-yl)thieno[3,2- -d]pyrimidin-2-amine
57. N-(3,4-dimethoxyphenyl)-7-(2,4-dimethoxypyrimidin-5-yl)thieno[3,2-d]pyrim- idin-2-amine
58. 7-iodo-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine 59. N-tert-butyl-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-
-7-yl)benzenesulfonamide 60. 2-cyano-N-(4-methyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin--
7-yl)phenyl)acetamide 61. ethyl 3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzoate
62. 7-bromo-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-a- mine
63. N-(3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]py- rimidin-7-yl)phenyl)acetamide
64. N-(cyanomethyl)-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl- )benzamide
65. N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be- nzamide
66. N-tert-butyl-3-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]p- yrimidin-7-yl)benzenesulfonamide
67. tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-pyr-
azole-1-carboxylate 68. 7-bromo-N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)thieno[3,2-d]pyrimidin-
-2-amine 69. N-tert-butyl-3-(2-(4-((4-ethylpiperazin-1-yl)methyl)phenylamino)thieno[3,-
2-d]pyrimidin-7-yl)benzenesulfonamide 70. N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-
-d]pyrimidin-2-amine 71. N-(cyanomethyl)-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimi-
din-7-yl)benzamide 72. N-tert-butyl-3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]-
pyrimidin-7-yl)benzenesulfonamide 73. tert-butyl pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate
74. 3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyri- midin-7-yl)benzenesulfonamide
75. 7-(3-chloro-4-fluorophenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno- [3,2-d]pyrimidin-2-amine
76. tert-butyl 4-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl-
)-1H-pyrazole-1-carboxylate 77. 7-(benzo[d][1,3]dioxol-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]p-
yrimidin-2-amine 78. tert-butyl 5-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-ind-
ole-1-carboxylate 79. 7-(2-aminopyrimidin-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyri-
midin-2-amine 80. tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-5,6-di-
hydropyridine-1(2H)-carboxylate 81. tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate
82. N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)- phenyl)acetamide
83. N-(4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide
84. N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phen- yl)methanesulfonamide
85. 7-(4-(4-methylpiperazin-1-yl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno- [3,2-d]pyrimidin-2-amine
86. N-(2-methoxy-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin- -7-yl)phenyl)acetamide
87. 7-bromo-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine 88. (3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)met-
hanol 89. (4-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)p- henyl)methanol
90. (3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methano- 1 91.
(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)me- thanol 92. N-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7--yl)benzyl)methanesulfonamide
93. tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate
94. N-(4-(morpholinomethyl)phenyl)-7-(3-(piperazin-1-yl)phenyl)thieno[3,2- -d]pyrimidin-2-amine
95. 7-(6-(2-morpholinoethylamino)pyridin-3--yl)-N-(3,4,5-trimethoxyphenyl)thie- no[3,2-d]pyrimidin-2-amine
96. 7-(2-ethylphenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine
97. 7-(4-(aminomethyl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine
98. N-(4-(1-ethylpiperidin-4-yloxy)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine
99. N-(2,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine 100. 7-bromo-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine
101. N-(3,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine
[0153] The present invention also relates to the pharmaceutically acceptable acid addition
salts of compounds of Formulas A and B, as well as the additional JAK inhibitors described
herein. The acids which are used to prepare the pharmaceutically acceptable acid addition
salts of the aforementioned base compounds of this invention are those which form
non-toxic acid addition salts, i.e., salts containing pharmacologically acceptable
anions, such as the hydrochloride, hydrobromide, hydroiodide, nitrate, sulfate, bisulfate,
phosphate, acid phosphate, acetate, lactate, citrate, acid citrate, tartrate, bitartrate,
succinate, maleate, fumarate, gluconate, saccharate, benzoate, methanesulfonate, ethanesulfonate,
benzenesulfonate, p-toluenesulfonate and pamoate [i.e., 1,1'-methylene-bis-(2-hydroxy-3-naphthoate)]
salts.
[0154] The invention also relates to base addition salts of Formulas A and B. The chemical
bases that may be used as reagents to prepare pharmaceutically acceptable base salts
of those compounds of Formulas A and B that are acidic in nature are those that form
non-toxic base salts with such compounds. Such non-toxic base salts include, but are
not limited to those derived from such pharmacologically acceptable cations such as
alkali metal cations (e.g., potassium and sodium) and alkaline earth metal cations
(e.g., calcium and magnesium), ammonium or water-soluble amine addition salts such
as N-methylglucamine-(meglumine), and the lower alkanolammonium and other base salts
of pharmaceutically acceptable organic amines.
[0155] The compounds of this invention include all conformational isomers (e.g., cis and
trans isomers. The compounds of the present invention have asymmetric centers and
therefore exist in different enantiomeric and diastereomeric forms. This invention
relates to the use of all optical isomers and stereoisomers of the compounds of the
present invention, and mixtures thereof, and to all pharmaceutical compositions and
methods of treatment that may employ or contain them. In this regard, the invention
includes both the E and Z configurations. The compounds of Formulas A and B can also
exist as tautomers. This invention relates to the use of all such tautomers and mixtures
thereof.
[0156] This invention also encompasses pharmaceutical compositions containing prodrugs of
compounds of the Formulas A and B, and their use in treating or preventing HIV. This
invention also encompasses methods of treating or preventing viral infections that
can be treated or prevented by protein kinase inhibitors, such as the enzyme Janus
Kinase 1, 2, or 3, comprising administering prodrugs of compounds of the Formulas
A and B. Compounds of Formulas A and B having free amino, amido, hydroxy or carboxylic
groups can be converted into prodrugs. Prodrugs include compounds wherein an amino
acid residue, or a polypeptide chain of two or more (e.g., two, three or four) amino
acid residues which are covalently joined through peptide bonds to free amino, hydroxy
or carboxylic acid groups of compounds of Formulas A and B. The amino acid residues
include the 20 naturally occurring amino acids commonly designated by three letter
symbols and also include, 4-hydroxyproline, hydroxylysine, demosine, isodemosine,
3-methylhistidine, norvlin, beta-alanine, gamma-aminobutyric acid, citrulline, homocysteine,
homoserine, ornithine and methioine sulfone. Prodrugs also include compounds wherein
carbonates, carbamates, amides and alkyl esters which are covalently bonded to the
above substituents of Formulas A and B through the carbonyl carbon prodrug sidechain.
II. Combinations of JAK Inhibitors and Other Antiviral Agents
[0157] In one embodiment, the compositions include antiretroviral JAK inhibitors as described
herein and one or more additional antiviral agents.
[0158] In one aspect of this embodiment, the JAK inhibitors and additional antiviral agents
are administered in combination or alternation, and in one aspect, in a manner in
which both agents act synergistically against the virus. The compositions and methods
described herein can be used to treat patients infected with a drug resistant form
of HIV, specifically, a form including the M184V/I, multidrug resistant viruses (e.g.,
Q151M), K65R mutation, Thymidine analog mutations (TAMS), and the like. TAMS include,
but are not limited to, mutations at reverse transcriptase (RT) positions 41, 67,
70, 210, 215, and 219, which confer clinically significant resistance to each of the
nucleoside RT inhibitors with the exception of 3TC.
[0159] While not wishing to be bound to a particular theory, it is believed that the JAK
inhibitors described herein function in a way not associated with heretofore known
antiretroviral therapy, in that the compounds do not act in the same way as NRTI,
NNRTI, protease inhibitors, integrase inhibitors, entry inhibitors, and the like,
all of which interfere directly with a step in the viral replication cycle. Rather,
they act in an intracellular manner, in a way that is not likely to provoke resistance.
More specifically, the mechanism is independent and distinct from direct modulation
or interference with the viral replication cycle itself, and therefore lacks a selective
pressure to confer emergence of drug resistant virus.
[0160] Further, the combination of the JAK inhibitors described herein, and one or more
additional antiviral agents, can help prevent the development of viral resistance
to other antiviral agents. Therefore, co-formulation of the JAK inhibitors with these
additional antiviral agents can function as a "resistance repellent" for the various
mutations associated with conventional therapy, and provides better therapy than either
alone.
[0161] In one aspect of this embodiment, a combination therapy is administered that has
the capability of attacking HIV in a variety of mechanisms. That is, the combination
therapy includes an effective amount of at least one adenine, cytosine, thymine, and
guanosine nucleoside antiviral, as well as one or more additional agents other than
NRTI that inhibit HIV viral loads via a different mechanism. Examples include reverse
transcriptase inhibitors, protease inhibitors, fusion inhibitors, entry inhibitors,
attachment inhibitors, polymerase inhibitors, and integrase inhibitors such as integrase
inhibitors such as raltegravir (Isentress) or MK-0518, GS-9137 (Gilead Sciences),
GS-8374 (Gilead Sciences), or GSK-364735.
[0162] It is believed that this therapy, particularly when administered at an early stage
in the development of HIV infection, has the possibility of eliminating HIV infection
in a patient. That is, the presence of the different nucleosides and additional agents
minimizes the ability of the virus to adapt its reverse transcriptase and develop
resistance to any class of nucleoside antiviral nucleosides (i.e., adenine, cytosine,
thymidine, or guanine), because it would be susceptible to at least one of the other
nucleoside antiviral agents that are present, and/or the additional non-NRTI therapeutic
agent. In addition the lipophilic character of certain agents would allow them to
penetrate certain compartments where virus could replicate (e.g., brain, testicles,
gut).
[0163] Representative agents are described in more detail below.
Attachment and Fusion Inhibitors
[0164] Attachment and fusion inhibitors are anti-HIV drugs which are intended to protect
cells from infection by HIV by preventing the virus from attaching to a new cell and
breaking through the cell membrane. These drugs can prevent infection of a cell by
either free virus (in the blood) or by contact with an infected cell. These agents
are susceptible to digestive acids, so are commonly delivered by break them down,
most of these drugs are given by injections or intravenous infusion.
[0165] Examples are shown in the table that follows:
Entry Inhibitors (including Fusion Inhibitors)
[0166]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
Fuzeon™ |
enfuvirtide |
|
T-20 |
Trimeris |
|
|
|
T-1249 |
Trimeris |
|
|
|
AMD-3100 |
AnorMED, Inc |
|
CD4-IgG2 |
|
PRO-542 |
Progenics Pharmaceuticals |
|
|
|
BMS-488043 |
Bristol-Myers Squibb |
|
aplaviroc |
|
GSK-873,140 |
GlaxoSmithKline |
|
Peptide T |
|
|
Advanced Immuni T, Inc. |
|
|
|
TNX-355 |
Tanox, Inc. |
|
maraviroc |
|
UK-427,857 |
Pfizer |
CXCR4 Inhibitor |
|
AMD070 |
|
AMD 11070 |
AnorMED, Inc |
CCR5 antagonist |
Vicriroc |
|
SCH-D |
SCH-417690 |
Schering-Plough |
[0167] Additional fusion and attachment inhibitors in human trials include AK602, AMD070,
BMS-378806, HGS004, INCB9471, PRO 140, Schering C, SP01A, and TAK-652.
[0168] AK602 is a CCR5 blocker being developed by Kumamoto University in Japan.
[0169] AMD070 by AnorMed blocks the CXCR4 receptor on CD4 T-cells to inhibit HIV fusion.
[0170] BMS-378806 is an attachment inhibitor that attaches to gp120, a part of HIV.
[0171] HGS004 by Human Genome Sciences, is a monoclonal antibody CCR5 blocker.
[0172] INCB 9471 is sold by Incyte Corporation.
[0173] PRO 140 by Progenics blocks fusion by binding to a receptor protein on the surface
of CD4 cells.
[0174] SP01A by Samaritan Pharmaceuticals is an HIV entry inhibitor.
[0175] TAK-652 by Takeda blocks binding to the CCR5 receptor.
Polymerase Inhibitors
[0176] The DNA polymerization activity of HIV-1 reverse transcriptase (RT) can be inhibited
by at least three mechanistically distinct classes of compounds. Two of these are
chain terminating nucleoside analogs (NRTIs) and allosteric non-nucleoside RT inhibitors
(NNRTIs). The third class includes pyrophosphate mimetics such as foscarnet (phosphonoformic
acid, PFA).
[0177] The reverse transcriptase has a second enzymatic activity, ribonuclease H (RNase
H) activity, which maps to a second active site in the enzyme. RNase H activity can
be inhibited by various small molecules (polymerase inhibitors). Examples include
diketo acids, which bind directly to the RNase H domain, or compounds like PFA, which
are believed to bind in the polymerase domain.
[0178] Examples of these compounds are listed in the tables that follow.
HIV Therapies: Nucleoside/Nucleotide Reverse
Transcriptase Inhibitors (NRTIs)
[0179]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
|
Dapavir, 2,6-diaminopurine dioxolane |
DAPD |
|
RFS Pharma |
Retrovir® |
zidovudine |
AZT or ZDV |
|
GlaxoSmithKline |
Epivir® |
lamivudine |
3TC |
|
GlaxoSmithKline |
Combivir® |
zidovudine + lamivudine |
AZT + 3TC |
|
GlaxoSmithKline |
Trizivir® |
abacavir + zidovudine + lamivudine |
ABC + AZT + 3TC |
|
GlaxoSmithKline |
Ziagen® |
abacavir |
ABC |
1592U89 |
GlaxoSmithKline |
Epzicom™ |
abacavir + lamivudine |
ABC + 3TC |
|
GlaxoSmithKline |
Hivid® |
zalcitabine |
ddC |
|
Hoffmann-La Roche |
Videx® |
didanosine: buffered versions |
ddI |
BMY-40900 |
Bristol-Mvers Squibb |
Entecavir |
baraclude |
|
|
Bristol-Myers Squibb |
Videx® EC |
didanosine: delayed-release capsules |
ddI |
|
Bristol-Myers Squibb |
Zerit® |
stavudine |
d4T |
BMY-27857 |
Bristol-Myers Squibb |
Viread™ |
tenofovir disoproxil fumarate (DF) |
TDF or Bis(POC) PMPA |
|
Gilead Sciences |
Emtriva® |
emtricitabine |
(-)-FTC |
|
Gilead Sciences |
Truvada® |
Viread + Emtriva |
TDF + (-)-FTC |
|
Gilead Sciences |
Atripla™ |
|
TDF + (-)-FTC + Sustiva® |
|
Gilead/BMS/Merck |
|
Amdoxovir |
DAPD, AMDX |
|
RFS Pharma LLC |
Apricitabine |
AVX754 |
|
SPD 754 |
Avexa Ltd |
|
Alovudine |
FLT |
MIV-310 |
Medivir |
|
Elvucitabine |
L-FD4C |
ACH-126443, |
Achillion |
|
KP-1461 |
|
SN1461, SN1212 |
Koronis |
|
Racivir |
RCV |
|
Emory University |
|
|
DOT |
|
Emory University |
Dexelvucitabine |
Reverset |
D-D4FC, DFC |
DPC 817 |
Emory University |
|
|
|
GS9148 and prodrugs thereof |
Gilead Sciences |
HIV Therapies: Non-Nucleoside Reverse
Transcriptase Inhibitors (NNRTIs)
[0180]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
Viramune® |
nevirapine |
NVP |
BI-RG-587 |
Boehringer Ingelheim |
Rescriptor® |
delavirdine |
DLV |
U-90152S/T |
Pfizer |
Sustiva® |
efavirenz |
EFV |
DMP-266 |
Bristol-Myers Squibb |
|
(+)-calanolide A |
|
|
Sarawak Medichem |
|
capravirine |
CPV |
AG-1549 or S-1153 |
Pfizer |
|
|
|
DPC-083 |
Bristol-Myers Squibb |
|
|
|
TMC-125 |
Tibotec-Virco Group |
|
|
|
TMC-278 |
Tibotec-Virco Group |
|
|
|
IDX12899 |
Idenix |
|
|
|
IDX12989 |
Idenix |
RDEA806 |
|
|
|
Ardea Bioscience, Inc. |
Integrase Inhibitors
[0181] Representative integrase inhibitors include globoidnan A, L-000870812, S/GSK1349572,
S/GSK1265744, Raltegravir and Elvitegravir with or without a pharmacokinetic (PK)
booster such as ritonavir or Gilead's pharmacoenhancing agent (also referred to as
a PK booster), GS 9350.
[0190] U.S. Patent Application No. 12/162,975, entitled "USE OF 6-(3-CHLORO-2-FLUOROBENZYL)-1-[(2S)-1-HYDROXY-3-METHYLBUTAN-2-YL]-7-METHOXY-4-OXO-1,4-DIHYDROQUINOLINE-3-CARBOXYLIC
ACID OR SALT THEREOF FOR TREATING RETROVIRUS INFECTION" filed in the name of Yuji
Matsuzaki, et al. on February 1, 2007 and published on January 15, 2009 as
U.S. Publication No. 20090018162.
[0211] PCT WO 2007/019098, entitled "HIV INTEGRASE INHIBITORS," listing SmithKline Beecham Corporation, Shionogi
& Co. Ltd., and Takashi Kawasuji as applicants, and Brian Johns as an inventor, published
on February 15, 2007.
[0247] Additional integrase inhibitors include L-870,810 (Merck), INH-001 (Inhibitex), L870810
(Merck), PL-2500, composed of pryidoxal 1-5-phosphate derivatives (Procyon) monophores
(Sunesis), V-165 (Rega Institute, Belgium), Mycelium integrasone (a fungal polyketide,
Merck), GS 9224 (Gilead Sciences), AVX-I (Avexa), ITI-367, an oxadiazol pre-integrase
inhibitor (
George Washington University), GSK364735 (
GSK/
Shionogi), GS-9160 (GSK), S-1360 (Shionogi-GlaxoSmithKline Pharmaceuticals LLC), RSC 1838
(GSK/Shionogi), GS-9137 (taken alone or with Norvir) (Gilead), MK-2048 (Merck), S/GSK
1349572 and S/GSK 1265744 (no need for a PK booster) (GSK/Shionogi), 6-(3-chloro-2-fluorobenzyl)-1-[(2S)-1-hydroxy-3-methylbutan-2-y-
l]-7-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid (
U.S. Patent Application Publication No. 20090018162), S-1360, L-870810, MK-0518 (Merck), C-2507 (Merck), BMS 538158 (Bristol Myers Squibb),
and L-900564 (Merck).
[0248] The structure of L-900564 is shown below:

Protease Inhibitors
[0256] Protease inhibitors treat or prevent HIV infection by preventing viral replication.
They act by inhibiting the activity of HIV protease, an enzyme that cleaves nascent
proteins for final assembly of new virons. Examples are shown in the table that follows.
HIV Therapies: Protease Inhibitors (PIs)
[0257]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
Invirase® |
saquinavir (Hard Gel Cap) |
SQV (HGC) |
Ro-31-8959 |
Hoffmann-La Roche |
Fortovase® |
saquinavir (Soft Gel Cap) |
SQV (SGC) |
|
Hoffmann-La Roche |
Norvir® |
Ritonavir |
RTV |
ABT-538 |
Abbott Laboratories |
Crixivan® |
Indinavir |
IDV |
MK-639 |
Merck & Co. |
Viracept® |
Nelfinavir |
NFV |
AG-1343 |
Pfizer |
Agenerase® |
Amprenavir |
APV |
141W94 or VX-478 |
GlaxoSmithKline |
Kaletra® |
lopinavir + ritonavir |
LPV |
ABT-378/r |
Abbott Laboratories |
Lexiva® |
fosamprenavir |
|
GW-433908 or VX-175 |
GlaxoSmithKline |
Aptivus® |
tripanavir |
TPV |
PNU-140690 |
Boehringer Ingelheim |
Reyataz® |
atazanavir |
|
BMS-232632 |
Bristol-Myers Squibb |
|
Brecanavir |
|
GW640385 |
GlaxoSmithKline |
Prezista™ |
Darunavir |
|
TMC114 |
Tibotec |
HIV Therapies: Other Classes of Drugs
[0258]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
Viread™ |
tenofovir disoproxil fumarate (DF) |
TDF or Bis(POC) PMPA |
|
Gilead Sciences |
Cellular Inhibitors
[0259]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
Droxia® |
Hydroxyurea |
HU |
|
Bristol-Myers Squibb |
HIV Therapies: Immune-Based Therapies
[0260]
Brand Name |
Generic Name |
Abbreviation |
Experimental Code |
Pharmaceutical Company |
Proleukin® |
aldesleukin, or Interleukin-2 |
IL-2 |
|
Chiron Corporation |
Remune® |
HIV-1 Immunogen, or Salk vaccine |
|
AG1661 |
The Immune Response Corporation |
|
|
|
HE2000 |
HollisEden Pharmaceuticals |
III. Combination or Alternation HIV-Agents
[0261] In general, during alternation therapy, an effective dosage of each agent is administered
serially, whereas in combination therapy, an effective dosage of two or more agents
is administered together. In alternation therapy, for example, one or more first agents
can be administered in an effective amount for an effective time period to treat the
viral infection, and then one or more second agents substituted for those first agents
in the therapy routine and likewise given in an effective amount for an effective
time period.
[0262] The dosages will depend on such factors as absorption, biodistribution, metabolism
and excretion rates for each drug as well as other factors known to those of skill
in the art. It is to be noted that dosage values will also vary with the severity
of the condition to be alleviated. It is to be further understood that for any particular
subject, specific dosage regimens and schedules should be adjusted over time according
to the individual need and the professional judgment of the person administering or
supervising the administration of the compositions.
[0263] Examples of suitable dosage ranges for anti-HIV compounds, including the JAK inhibitors
described herein, can be found in the scientific literature and in the Physicians
Desk Reference. Many examples of suitable dosage ranges for other compounds described
herein are also found in public literature or can be identified using known procedures.
These dosage ranges can be modified as desired to achieve a desired result.
[0264] Certain JAK inhibitors described herein are also inhibitors of CYP3A4, which means
that they will significantly increase the C
max plasma level of any anti-HIV drug that binds to CYP3A4, including HIV-1 protease
inhibitors. This information can be taken into consideration when determining suitable
dosages for such compounds.
IV. Combination Therapy for Treating an HCV Infection
[0265] Nonlimiting examples of additional agents include:
HCV Protease inhibitors: Examples include Medivir HCV Protease Inhibitor (HCV-PI or
TMC435) (Medivir/Tibotec); MK-7009 (Merck), RG7227 (ITMN-191) (Roche/Pharmasset/InterMune),
boceprevir (SCH 503034) (Schering), SCH 446211 (Schering), narlaprevir SCH900518 (Schering/Merck),
ABT-450 (Abbott/Enanta), ACH- 1625 (Achillion), BI 201335 (Boehringer Ingelheim),
PHX1766 (Phenomix), VX-500 (Vertex) and telaprevir (VX-950) (Vertex). Further examples
of protease inhibitors include substrate-based NS3 protease inhibitors (Attwood et
al., Antiviral peptide derivatives,
PCT WO 98/22496, 1998;
Attwood et al, Antiviral Chemistry and Chemotherapy 1999, 10, 259- 273; Attwood et al., Preparation and use of amino acid derivatives as anti-viral agents,
German Patent Pub.
DE 19914474; Tung et al., Inhibitors of serine proteases, particularly hepatitis C virus NS3
protease,
PCT WO 98/17679), including alphaketoamides and hydrazinoureas, and inhibitors that terminate in
an electrophile such as a boronic acid or phosphonate (Llinas-Brunet et al, Hepatitis
C inhibitor peptide analogues,
PCT WO 99/07734); Non-substrate-based NS3 protease inhibitors such as 2,4,6-trihydroxy-3-nitro-benzamide
derivatives (
Sudo K. et al, Biochemical and Biophysical Research Communications, 1997, 238, 643-647;
Sudo K. et al., Antiviral Chemistry and Chemotherapy, 1998, 9, 186), including RD3-4082 and RD3-4078, the former substituted on the amide with a 14
carbon chain and the latter processing a para-phenoxyphenyl group; and Sch 68631 ,
a phenanthrenequinone, an HCV protease inhibitor (
Chu M. et al., Tetrahedron Letters 37:7229-7232, 1996).
[0266] SCH 351633, isolated from the fungus Penicillium griseofulvum, was identified as
a protease inhibitor (
Chu M., et al., Bioorganic and Medicinal Chemistry Letters 9 : 1949- 1952). Eglin c, isolated from leech, is a potent inhibitor of several serine proteases
such as S. griseus proteases A and B, a-chymotrypsin, chymase and subtilisin.
Qasim M.A. et al., Biochemistry 36: 1598-1607, 1997.
[0267] U.S. patents disclosing protease inhibitors for the treatment of HCV include, for
example,
U.S. Patent No. 6,004,933 to Spruce et al., which discloses a class of cysteine protease inhibitors for inhibiting HCV endopeptidase
2;
U.S. Patent No. 5,990,276 to Zhang et al., which discloses synthetic inhibitors of hepatitis C virus NS3 protease;
U.S. Patent No. 5,538,865 to Reyes et a;
WO 02/008251 to Corvas International, Inc, and
US7, 169,760,
US2005/176648,
WO 02/08187 and
WO 02/008256 to Schering Corporation. HCV inhibitor tripeptides are disclosed in
U.S. Patent Nos. 6,534,523,
6,410,531, and
6,420,380 to Boehringer Ingelheim and
WO 02/060926 to Bristol Myers Squibb. Diaryl peptides as NS3 serine protease inhibitors of HCV
are disclosed in
WO 02/48172 and
US 6,911,428 to Schering Corporation. Imidazoleidinones as NS3 serine protease inhibitors of HCV
are disclosed in
WO 02/08198 and
US 6,838,475 to Schering Corporation and
WO 02/48157 and
US 6,727,366 to Bristol Myers Squibb.
WO 98/17679 and
US 6,265,380 to Vertex Pharmaceuticals and
WO 02/48116 and
US 6,653,295 to Bristol Myers Squibb also disclose HCV protease inhibitors. Further examples of
HCV serine protease inhibitors are provided in
US 6,872,805 (Bristol-Myers Squibb);
WO 2006000085 (Boehringer Ingelheim);
US 7,208,600 (Vertex);
US 2006/0046956 (Schering-Plough);
WO 2007/001406 (Chiron);
US 2005/0153877;
WO 2006/119061 (Merck);
WO 00/09543 (Boehringer Ingelheim),
US 6,323,180 (Boehringer Ingelheim)
WO 03/064456 (Boehringer Ingelheim),
US 6,642,204(Boehringer Ingelheim),
WO 03/064416 (Boehringer Ingelheim),
US 7,091,184 (Boehringer Ingelheim),
WO 03/053349 (Bristol-Myers Squibb),
US 6,867,185,
WO 03/099316 (Bristol-Myers Squibb),
US 6,869,964,
WO 03/099274 (Bristol-Myers Squibb),
US 6,995,174,
WO 2004/032827 (Bristol-Myers Squibb),
US 7,041,698,
WO 2004/043339 and
US 6,878,722 (Bristol-Myers Squibb).
[0268] Thiazolidine derivatives which show relevant inhibition in a reverse-phase HPLC assay
with an NS3/4A fusion protein and NS5A/5B substrate (
Sudo K. et al, Antiviral Research, 1996, 32, 9-18), especially compound RD-1-6250, possessing a fused cinnamoyl moiety substituted
with a long alkyl chain, RD4 6205 and RD4 6193;
Thiazolidines and benzanilides identified in
Kakiuchi N. et al, J. EBS Letters 421, 217-220;
Takeshita N. et al, Analytical Biochemistry, 1997, 247, 242-246;
A phenanthrenequinone possessing activity against protease in a SDS-PAGE and autoradiography
assay isolated from the fermentation culture broth of Streptomyces sp., SCH 68631
(
Chu M. et al, Tetrahedron Letters, 1996, 37, 7229-7232), and SCH 351633, isolated from the fungus Penicillium griseofulvum, which demonstrates
activity in a scintillation proximity assay (
Chu M. et al, Bioorganic and Medicinal Chemistry Letters 9, 1949-1952);
Helicase inhibitors (Diana G.D. et al, Compounds, compositions and methods for treatment
of hepatitis C,
U.S. Pat. No. 5,633,358; Diana G.D. et al, Piperidine derivatives, pharmaceutical compositions thereof and
their use in the treatment of hepatitis C,
PCT WO 97/36554);
HCV polymerase inhibitors, including nucleoside and non-nucleoside polymerase inhibors,
such as ribavirin, viramidine, clemizole, filibuvir (PF-00868554), HCV POL, NM-283
(valopicitabine), MK-0608, 7-Fluoro-MK-0608, MK-3281, IDX-375, ABT-072, ABT- 333,
ANA598, BI 207127, GS 9190, PSI-6130, R1626, PSI-6206, PSI-35938, PSI-7851, PSI-7977,
RG1479, RG7128, HCV-796 VCH-759 or VCH-916, and salts and prodrugs thereof.
[0269] Gliotoxin (
Ferrari R. et al, Journal of Virology, 1999, 73, 1649-1654), and the natural product cerulenin (
Lohmann V. et al., Virology, 1998, 249, 108-118);
Interfering RNA (iRNA) based antivirals, including short interfering RNA (siRNA) based
antivirals, such as Sirna-034 and others described in International Patent Publication
Nos.
WO/03/070750 and
WO 2005/012525, and U.S. Patent Publication No.
US 2004/0209831.
[0270] Antisense phosphorothioate oligodeoxynucleotides (S-ODN) complementary to sequence
stretches in the 5' non-coding region (NCR) of the virus (
Alt M. et al., Hepatology, 1995, 22, 1 'O '-717), or nucleotides 326-348 comprising the 3' end of the NCR and nucleotides 371-388
located in the core coding region of the HCV RNA (
Alt M. et al, Archives of Virology, 1997, 142, 589-599;
Galderisi U. et al, Journal of Cellular Physiology, 1999, 181, 251-257);
Inhibitors of IRES-dependent translation (Ikeda N et al., Agent for the prevention
and treatment of hepatitis C, Japanese Patent Pub.
JP-08268890; Kai Y. et al, Prevention and treatment of viral diseases, Japanese Patent Pub.
JP-10101591);
HCV entry inhibitors, such as celgosivir (MK-3253) (MIGENIX Inc.), SP-30 (Samaritan
Pharmaceuticals), ITX4520 (iTherX), ITX5061 (iTherX), PRO-206 (Progenies Pharmaceuticals)
and other entry inhibitors by Progenies Pharmaceuticals, e.g., as disclosed in
U.S. Patent Publication No. 2006/0198855.
[0271] Ribozymes, such as nuclease-resistant ribozymes (
Maccjak, D. J. et al, Hepatology 1999, 30, abstract 995) and those disclosed in
U.S. Patent No. 6,043,077 to Barber et al, and
U.S. Patent Nos. 5,869,253 and
5,610,054 to Draper et al; and
Nucleoside analogs have also been developed for the treatment of Flaviviridae infections.
[0273] Other patent applications disclosing the use of certain nucleoside analogs that can
be used as second agents to treat hepatitis C virus include:
PCT/CAOO/01316 (
WO 01/32153; filed November 3, 2000) and
PCT/CA01/00197 (
WO 01/60315; filed February 19, 2001) filed by BioChem Pharma, Inc. (now Shire Biochem, Inc.);
PCT/US02/01531 (
WO 02/057425; filed January 18, 2002);
PCT/US02/03086 (
WO 02/057287; filed January 18, 2002);
US 7,202,224;
7,125,855;
7,105,499 and
6,777,395 by Merck & Co., Inc.;
PCT/EP01/09633 (
WO 02/18404; published August 21, 2001);
US 2006/0040890;
2005/0038240;
2004/0121980;
6,846,810;
6,784,166 and
6,660,721 by Roche;
PCT Publication Nos. WO 01/79246 (filed April 13, 2001),
WO 02/32920 (filed October 18, 2001),
WO 02/48165,
WO 05/003147;
US 2005/0009737;
US 2005/0009737;
7,094,770,
6,927,291,
WO 08/12163434,
WO 10/077554,
WO 09/152095,
WO 10/075549, and
WO 10/135569 by Pharmasset, Ltd.
[0274] Further compounds that can be used as second agents to treat hepatitis C virus are
disclosed in
PCT Publication No. WO 99/43691 to Emory University, entitled "2'-Fluoronucleosides". The use of certain 2'-fluoronucleosides
to treat HCV is disclosed.
[0275] Other miscellaneous compounds that can be used as second agents include 1-amino-alkylcyclohexanes
(
U.S. Patent No. 6,034,134 to Gold et al.), alkyl lipids (
U.S. Pat. No. 5,922,757 to Chojkier et al.), vitamin E and other antioxidants (
U.S. Pat. No. 5,922,757 to Chojkier et al.), squalene, amantadine, bile acids (
U.S. Pat. No. 5,846,964 to Ozeki et al.), N-(phosphonoacetyl)-L-aspartic acid, (
U.S. Pat. No. 5,830,905 to Diana et al.), benzenedicarboxamides (
U.S. Pat. No. 5,633,388 to Diana et al.), polyadenylic acid derivatives (
U.S. Pat. No. 5,496,546 to Wang et al.), 2',3'-dideoxyinosine (
U.S. Pat. No. 5,026,687 to Yarchoan et al.), benzimidazoles (
U.S. Pat. No. 5,891,874 to Colacino et al.), plant extracts (
U.S. Patent No. 5,837,257 to Tsai et al.,
U.S. Patent No. 5,725,859 to Omer et al., and
U.S. Patent No. 6,056,961), and piperidenes (
U.S. Patent No. 5,830,905 to Diana et al.).
Exemplary Additional Therapeutic Agents for Treatment of HCV
[0276] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with an anti-hepatitis C virus interferon, such as Intron A® (interferon
alfa-2b) and Pegasys® (Peginterferon alfa-2a); Roferon A® (Recombinant interferon
alfa-2a), Infergen® (consensus interferon; interferon alfacon-1), PEG-Intron® (pegylated
interferon alfa-2b) and Pegasys® (pegylated interferon alfa-2a), optionally in further
combination with ribavirin.
[0277] In one embodiment, the anti-hepatitis C virus interferon is infergen, IL-29 (PEG-
Interferon lambda), R7025 (Maxy-alpha), Belerofon, Oral Interferon alpha, BLX-883
(Locteron), omega interferon, multiferon, medusa interferon, Albuferon or REBIF®.
[0278] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with an anti-hepatitis C virus polymerase inhibitor, such as ribavirin,
viramidine, HCV POL, NM-283 (valopicitabine), PSI-7977, PSI-938, MK-0608, 7-Fluoro-MK-0608,
PSI-6130, R1626, IDX-184, INX-189, PSI-6206, PSI-35938, R1479, HCV-796 or R7128.
[0279] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with an anti-HCVprotease inhibitor such as ITMN- 191, SCH 503034, VX950
(telaprevir), GNS-227, or Medivir HCV Protease Inhibitor.
[0280] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with an anti-HCV vaccine, such as TG4040, PeviPROTM, CGI-5005, HCV/MF59,
GV1001, IC41 or INNO0101 (El).
[0281] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with an anti-HCV monoclonal antibody, such as AB68 or XTL-6865 (formerly
HepX-C); or an anti-hepatitis C virus polyclonal antibody, such as cicavir.
[0282] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with an anti-hepatitis C virus immunomodulator, such as Zadaxin® (thymalfasin),
NOV-205 or Oglufanide.
[0283] In one embodiment, one or more compounds provided herein can be administered in combination
or alternation with Nexavar, doxorubicin, PI-88, amantadine, JBK-122, VGX- 4 IOC,
MX-3253 (Ceglosivir), Suvus (BIVN-401 or virostat), PF-03491390 (formerly IDN- 6556),
G126270, UT-231B, DEBIO-025, EMZ702, ACH-0137171, MitoQ, ANA975, AVI- 4065, Bavituxinab
(Tarvacin), Alinia (nitrazoxanide) or PYN17.
Prodrug Forms
[0284] The 5'- hydroxyl moiety in the nucleosides described herein, and hydroxy groups on
the JAK inhibitors described herein, can be modified to be in prodrug form. For example,
the 5'-hydroxy in nucleosides can be replaced with a 5'-OR
1 moiety, where R
1 is an optionally substituted alkyl, an optionally substituted cycloalkyl, an optionally
substituted aralkyl, dialkylaminoalkylene, alkyl-C(=O)-, aryl-C(=O)-, alkoxyalkyl-C(=O)-,
aryloxyalkyl-C(=O)-, alkylsulfonyl, arylsulfonyl, aralkylsulfonyl, an -O-linked amino
acid, diphosphate, triphosphate or derivatives thereof, or

wherein:
V1 is O or S;
R10 is selected from O-, -OH, an optionally substituted aryloxy or heteroaryl-oxy-, alkyl-C(=O)-O-CH2-O-, alkyl-C(=O)-S-CH2CH2-O-, pivaloyloxymethyl, - NH-CH2-aryl, -O-CH2-O-C(O)-ORa1, an -N-linked amino acid, an -N-linked amino acid ester,

and

or OR
1 can be

or
where Ar1 is selected from phenyl, pyridinyl, monocyclic heteroaryl, substituted phenyl with
1-3 substituents, and monoheterocyclic heteroaryl with 1-2 substitutents, wherein
each substituent is independently selected from the group consisting of -F, -Cl, -Br,
-I, C1-6 alkyl, -CF3, -OMe, -NMe2, -OEt, -CO2Ra1, - CONH2, -SMe, -S(=O)2Me, -S(=O)2NH2, and CN;
or R1 and R10 can combine to form a cyclic phosphate of the formula:
where R19 is selected from N-linked amino acid ester, ORa1 or OR20, wherein R20 is substituted aryl with 1-3 substituents, or substituted heteroaryl with 1-2 substituents,
wherein each substituent is independently selected from Ra1 and Rd1.
R11 is selected from O-, -OH, an optionally substituted aryloxy or aryl-O-, alkyl-C(=O)-O-CH2-O-, alkyl-C(=O)-S-CH2CH2-O-, pivaloyloxymethyl, -NH-CH2-aryl, -O-CH2-O-C(O)-ORa1, an -N-linked amino acid, an -N-linked amino acid ester,

and

or OR1 can be



or
where Ar1 is selected from phenyl, pyridinyl, monocyclic heteroaryl, substituted phenyl with
1-3 substituents, and monoheterocyclic heteroaryl with 1-2 substitutents, wherein
each substituent is independently selected from the group consisting of -F, -Cl, -Br,
-I, C1-6 alkyl, -CF3, -OMe, -NMe2, -OEt, -CO2Ra1, - CONH2, -SMe, -S(=O)2Me, -S(=O)2NH2, and CN;
or R1 and R10 can combine to form a cyclic phosphate of the formula:
where R19 is selected from N-linked amino acid ester, ORa1 or OR20, wherein R20 is substituted aryl with 1-3 substituents, or substituted heteroaryl with 1-2 substituents,
wherein each substituent is independently selected from Ra1 and Rd1,
each R12 and R13 are, independently, -C≡N or an optionally substituted substituent selected from C1-8 organylcarbonyl, C1-8 alkoxycarbonyl and C1-8 organylaminocarbonyl;
each R14 is hydrogen or an optionally substituted C1-6 alkyl;
each m is independently 1 or 2, and if both R10 and R11 are
each R12, each R13, each R14 and each m can be the same or different.
Ra1, Rb1, Rc1, and Rd1 are each independently selected from hydrogen, an optionally substituted alkyl, an
optionally substituted alkenyl, an optionally substituted alkynyl, an optionally substituted
aryl, an optionally substituted heteroaryl, an optionally substituted aralkyl and
an optionally substituted heteroaryl-(C1-6 alkyl).
[0285] In one embodiment, R
1 is a mono-phosphate, di-phosphate, tri-phosphate, or phosphate prodrug.
V. Pharmaceutical Compositions
[0286] Humans suffering from effects caused by any of the diseases described herein, and
in particular, HIV infection, can be treated by administering to the patient an effective
amount of the compositions described above, in the presence of a pharmaceutically
acceptable carrier or diluent, for any of the indications or modes of administration
as described in detail herein. The active materials can be administered by any appropriate
route, for example, orally, parenterally, enterally, intravenously, intradermally,
subcutaneously, transdermally, intranasally or topically, in liquid or solid form.
[0287] The active compounds are included in the pharmaceutically acceptable carrier or diluent
in an amount sufficient to deliver to a patient a therapeutically effective amount
of compound to inhibit viral propagation
in vivo, especially HIV propagation, without causing serious toxic effects in the treated
patient. While not wishing to be bound to a particular theory, it is believed that
the JAK inhibitors render the cellular milieu non-supportive of productive replication.
By "inhibitory amount" is meant an amount of active ingredient sufficient to exert
an inhibitory effect as measured by, for example, an assay such as the ones described
herein.
[0288] A preferred dose of the compound for all the above-mentioned conditions will be in
the range from about 1 to 75 mg/kg, preferably 1 to 20 mg/kg, of body weight per day,
more generally 0.1 to about 100 mg per kilogram body weight of the recipient per day.
The effective dosage range of the pharmaceutically acceptable derivatives can be calculated
based on the weight of the parent nucleoside or other agent to be delivered. If the
derivative exhibits activity in itself, the effective dosage can be estimated as above
using the weight of the derivative, or by other means known to those skilled in the
art.
[0289] The compounds are conveniently administered in unit any suitable dosage form, including
but not limited to one containing 7 to 3,000 mg, preferably 70 to 1,400 mg of active
ingredient per unit dosage form. An oral dosage of 50 to 1,000 mg is usually convenient.
[0290] Ideally, the active ingredient should be administered to achieve peak plasma concentrations
of the active compound of from about 0.02 to 70 micromolar, preferably about 0.5 to
10 micromolar. This may be achieved, for example, by the intravenous injection of
a 0.1 to 25% solution of the active ingredient, optionally in saline, or administered
as a bolus of the active ingredient.
[0291] The concentration of active compound in the drug composition will depend on absorption,
distribution, metabolism and excretion rates of the drug as well as other factors
known to those of skill in the art. It is to be noted that dosage values will also
vary with the severity of the condition to be alleviated. It is to be further understood
that for any particular subject, specific dosage regimens should be adjusted over
time according to the individual need and the professional judgment of the person
administering or supervising the administration of the compositions, and that the
concentration ranges set forth herein are exemplary only and are not intended to limit
the scope or practice of the claimed composition. The active ingredient may be administered
at once, or may be divided into a number of smaller doses to be administered at varying
intervals of time.
[0292] A preferred mode of administration of the active compound is oral. Oral compositions
will generally include an inert diluent or an edible carrier. They may be enclosed
in gelatin capsules or compressed into tablets. For the purpose of oral therapeutic
administration, the active compound can be incorporated with excipients and used in
the form of tablets, troches, or capsules. Pharmaceutically compatible bind agents,
and/or adjuvant materials can be included as part of the composition.
[0293] The tablets, pills, capsules, troches and the like can contain any of the following
ingredients, or compounds of a similar nature: a binder such as microcrystalline cellulose,
gum tragacanth or gelatin; an excipient such as starch or lactose, a disintegrating
agent such as alginic acid, Primogel, or corn starch; a lubricant such as magnesium
stearate or Sterotes; a glidant such as colloidal silicon dioxide; a sweetening agent
such as sucrose or saccharin; or a flavoring agent such as peppermint, methyl salicylate,
or orange flavoring. When the dosage unit form is a capsule, it can contain, in addition
to material of the above type, a liquid carrier such as a fatty oil. In addition,
dosage unit forms can contain various other materials which modify the physical form
of the dosage unit, for example, coatings of sugar, shellac, or other enteric agents.
[0294] The compounds can be administered as a component of an elixir, suspension, syrup,
wafer, chewing gum or the like. A syrup may contain, in addition to the active compounds,
sucrose as a sweetening agent and certain preservatives, dyes and colorings and flavors.
[0295] The compounds or their pharmaceutically acceptable derivative or salts thereof can
also be mixed with other active materials that do not impair the desired action, or
with materials that supplement the desired action, such as antibiotics, antifungals,
antiinflammatories, protease inhibitors, or other nucleoside or non-nucleoside antiviral
agents, as discussed in more detail above. Solutions or suspensions used for parental,
intradermal, subcutaneous, or topical application can include the following components:
a sterile diluent such as water for injection, saline solution, fixed oils, polyethylene
glycols, glycerine, propylene glycol or other synthetic solvents; antibacterial agents
such as benzyl alcohol or methyl parabens; antioxidants such as ascorbic acid or sodium
bisulfite; chelating agents such as ethylenediaminetetraacetic acid; buffers such
as acetates, citrates or phosphates and agents for the adjustment of tonicity such
as sodium chloride or dextrose. The parental preparation can be enclosed in ampoules,
disposable syringes or multiple dose vials made of glass or plastic.
[0296] If administered intravenously, preferred carriers are physiological saline or phosphate
buffered saline (PBS).
[0297] Liposomal suspensions (including liposomes targeted to infected cells with monoclonal
antibodies to viral antigens) are also preferred as pharmaceutically acceptable carriers,
these may be prepared according to methods known to those skilled in the art, for
example, as described in
U.S. Patent No. 4,522,811. For example, liposome formulations may be prepared by dissolving appropriate lipid(s)
(such as stearoyl phosphatidyl ethanolamine, stearoyl phosphatidyl choline, arachadoyl
phosphatidyl choline, and cholesterol) in an inorganic solvent that is then evaporated,
leaving behind a thin film of dried lipid on the surface of the container. An aqueous
solution of the active compound or its monophosphate, diphosphate, and/or triphosphate
derivatives is then introduced into the container. The container is then swirled by
hand to free lipid material from the sides of the container and to disperse lipid
aggregates, thereby forming the liposomal suspension.
[0298] In one embodiment, the composition is a co-formulated pill, tablet, or other oral
drug delivery vehicle including one or more of the JAK inhibitors described herein,
and optionally including one or more additional antiviral agents.
[0299] In another embodiment, the JAK inhibitors described herein are co-formulated with
ATRIPLA® (efavirenz 600 mg/emtricitabine [(-)-FTC] 200 mg/tenofovir disoproxil fumarate
300 mg), and, optionally, with a thymidine nRTI such as AZT and a guanine nRTI (or
a compound such as DAPD which is deaminated
in vivo to form a guanine nRTI, in this case, DXG). Because efavirenz is an NNRTI, tenofovir
is an adenine nRTI, (-)-FTC is a cytosine nRTI, and AZT is a thymidine nRTI, and DAPD
is deaminated in vivo to form DXG (a guanine NRTI), the combination of the coformulated
compounds will provide, in addition to the JAK inhibitors, all four bases (ACTG) plus
an additional agent capable of interacting with HIV in a different mechanism.
Controlled Release Formulations
[0300] All of the U.S. patents cited in this section on controlled release formulations
are incorporated by reference in their entirety.
[0301] The field of biodegradable polymers has developed rapidly since the synthesis and
biodegradability of polylactic acid was reported by
Kulkarni et al., in 1966 ("Polylactic acid for surgical implants," Arch. Surg., 93:839). Examples of other polymers which have been reported as useful as a matrix material
for delivery devices include polyanhydrides, polyesters such as polyglycolides and
polylactide-co-glycolides, polyamino acids such as polylysine, polymers and copolymers
of polyethylene oxide, acrylic terminated polyethylene oxide, polyamides, polyurethanes,
polyorthoesters, polyacrylonitriles, and polyphosphazenes. See, for example,
U.S. Pat. Nos. 4,891,225 and
4,906,474 to Langer (polyanhydrides),
U.S. Pat. No. 4,767,628 to Hutchinson (polylactide, polylactide-co-glycolide acid), and
U.S. Pat. No. 4,530,840 to Tice, et al. (polylactide, polyglycolide, and copolymers). See also
U.S. Pat. No. 5,626,863 to Hubbell, et al which describes photopolymerizable biodegradable hydrogels as tissue contacting materials
and controlled release carriers (hydrogels of polymerized and crosslinked macromers
comprising hydrophilic oligomers having biodegradable monomeric or oligomeric extensions,
which are end capped monomers or oligomers capable of polymerization and crosslinking);
and
PCT WO 97/05185 filed by Focal, Inc. directed to multiblock biodegradable hydrogels for use as controlled
release agents for drug delivery and tissue treatment agents.
[0303] Many dispersion systems are currently in use as, or being explored for use as, carriers
of substances, particularly biologically active compounds. Dispersion systems used
for pharmaceutical and cosmetic formulations can be categorized as either suspensions
or emulsions. Suspensions are defined as solid particles ranging in size from a few
manometers up to hundreds of microns, dispersed in a liquid medium using suspending
agents. Solid particles include microspheres, microcapsules, and nanospheres. Emulsions
are defined as dispersions of one liquid in another, stabilized by an interfacial
film of emulsifiers such as surfactants and lipids. Emulsion formulations include
water in oil and oil in water emulsions, multiple emulsions, microemulsions, microdroplets,
and liposomes. Microdroplets are unilamellar phospholipid vesicles that consist of
a spherical lipid layer with an oil phase inside, as defined in
U.S. Pat. Nos. 4,622,219 and
4,725,442 issued to Haynes. Liposomes are phospholipid vesicles prepared by mixing water-insoluble polar lipids
with an aqueous solution. The unfavorable entropy caused by mixing the insoluble lipid
in the water produces a highly ordered assembly of concentric closed membranes of
phospholipid with entrapped aqueous solution.
[0304] U.S. Pat. No. 4,938,763 to Dunn, et al., discloses a method for forming an implant in situ by dissolving a nonreactive, water
insoluble thermoplastic polymer in a biocompatible, water soluble solvent to form
a liquid, placing the liquid within the body, and allowing the solvent to dissipate
to produce a solid implant. The polymer solution can be placed in the body via syringe.
The implant can assume the shape of its surrounding cavity. In an alternative embodiment,
the implant is formed from reactive, liquid oligomeric polymers which contain no solvent
and which cure in place to form solids, usually with the addition of a curing catalyst.
[0305] A number of patents disclose drug delivery systems that can be used to administer
the combination of the thymidine and non-thymidine nucleoside antiviral agents, or
prodrugs thereof.
U.S. Pat. No. 5,749,847 discloses a method for the delivery of nucleotides into organisms by electrophoration.
U.S. Pat. No. 5,718,921 discloses microspheres comprising polymer and drug dispersed there within.
U.S. Pat. No. 5,629,009 discloses a delivery system for the controlled release of bioactive factors.
U.S. Pat. No, 5,578,325 discloses nanoparticles and microparticles of nonlinear hydrophilic hydrophobic multiblock
copolymers.
U.S. Pat. No. 5,545,409 discloses a delivery system for the controlled release of bioactive factors.
U.S. Pat. No. 5,494,682 discloses ionically cross-linked polymeric microcapsules.
[0306] U.S. Pat. No. 5,728,402 to Andrx Pharmaceuticals, Inc. describes a controlled release formulation that includes
an internal phase which comprises the active drug, its salt or prodrug, in admixture
with a hydrogel forming agent, and an external phase which comprises a coating which
resists dissolution in the stomach.
U.S. Pat. Nos. 5,736,159 and
5,558,879 to Andrx Pharmaceuticals, Inc. discloses a controlled release formulation for drugs
with little water solubility in which a passageway is formed in situ.
U.S. Pat. No. 5,567,441 to Andrx Pharmaceuticals, Inc. discloses a once-a-day controlled release formulation.
U.S. Pat. No. 5,508,040 discloses a multiparticulate pulsatile drug delivery system.
U.S. Pat. No. 5,472,708 discloses a pulsatile particle based drug delivery system.
U.S. Pat. No. 5,458,888 describes a controlled release tablet formulation which can be made using a blend
having an internal drug containing phase and an external phase which comprises a polyethylene
glycol polymer which has a weight average molecular weight of from 3,000 to 10,000.
U.S. Pat. No. 5,419,917 discloses methods for the modification of the rate of release of a drug form a hydrogel
which is based on the use of an effective amount of a pharmaceutically acceptable
ionizable compound that is capable of providing a substantially zero-order release
rate of drug from the hydrogel.
U.S. Pat. No. 5,458,888 discloses a controlled release tablet formulation.
[0307] U.S. Pat. No. 5,641,745 to Elan Corporation, plc discloses a controlled release pharmaceutical formulation
which comprises the active drug in a biodegradable polymer to form microspheres or
nanospheres. The biodegradable polymer is suitably poly-D,L-lactide or a blend of
poly-D,L-lactide and poly-D,L-lactide-co-glycolide.
U.S. Pat. No. 5,616,345 to Elan Corporation plc describes a controlled absorption formulation for once a
day administration that includes the active compound in association with an organic
acid, and a multi-layer membrane surrounding the core and containing a major proportion
of a pharmaceutically acceptable film-forming, water insoluble synthetic polymer and
a minor proportion of a pharmaceutically acceptable film-forming water soluble synthetic
polymer.
U.S. Pat. No. 5,641,515 discloses a controlled release formulation based on biodegradable nanoparticles.
U.S. Pat. No. 5,637,320 discloses a controlled absorption formulation for once a day administration.
U.S. Pat. Nos. 5,580,580 and
5,540,938 are directed to formulations and their use in the treatment of neurological diseases.
U.S. Pat. No. 5,533,995 is directed to a passive transdermal device with controlled drug delivery.
U.S. Pat. No. 5,505,962 describes a controlled release pharmaceutical formulation.
Prodrug Formulations
[0308] The JAK inhibitors, as well as the nucleosides or other compounds which are described
herein for use in combination or alternation therapy with the JAK inhibitors or their
related compounds, can be administered as an acylated prodrug or a nucleotide prodrug,
as described in detail below.
[0309] Any of the JAK inhibitors, nucleosides, or other compounds described herein that
contain a hydroxyl or amine function can be administered as a nucleotide prodrug to
increase the activity, bioavailability, stability or otherwise alter the properties
of the nucleoside. A number of nucleotide prodrug ligands are known. In general, alkylation,
acylation or other lipophilic modification of the hydroxyl group of the compound or
of the mono, di or triphosphate of the nucleoside will increase the stability of the
nucleotide. Examples of substituent groups that can replace one or more hydrogens
on the phosphate moiety or hydroxyl are alkyl, aryl, steroids, carbohydrates, including
sugars, 1,2-diacylglycerol and alcohols. Many are described in
R. Jones and N. Bischofberger, Antiviral Research, 27 (1995) 1 17. Any of these can be used in combination with the disclosed nucleosides or other
compounds to achieve a desire effect.
[0310] The active nucleoside or other hydroxyl containing compound can also be provided
as an ether lipid (and particularly a 5'-ether lipid for a nucleoside), as disclosed
in the following references,
Kucera, L. S., N. Iyer, E. Leake, A. Raben, Modest E. K., D. L. W., and C. Piantadosi.
1990. "Novel membrane-interactive ether lipid analogs that inhibit infectious HIV-1
production and induce defective virus formation." AIDS Res. Hum. Retroviruses. 6:491
501;
Piantadosi, C., J. Marasco C. J., S. L. Morris-Natschke, K. L. Meyer, F. Gumus, J.
R. Surles, K. S. Ishaq, L. S. Kucera, N. Iyer, C. A. Wallen, S. Piantadosi, and E.
J. Modest. 1991. "Synthesis and evaluation of novel ether lipid nucleoside conjugates
for anti-HIV activity." J. Med. Chem. 34:1408.1414;
Hosteller, K. Y., D. D. Richrnan, D. A. Carson, L. M. Stuhmiller, G. M. T. van Wijk,
and H. van den Bosch. 1992. "Greatly enhanced inhibition of human immunodeficiency
virus type 1 replication in CEM and HT4-6C cells by 3'-deoxythymidine diphosphate
dimyristoylglycerol, a lipid prodrug of 3'-deoxythymidine." Antimicrob. Agents Chemother.
36:2025.2029;
Hostetler, K. Y., L. M. Stuhmiller, H. B. Lenting, H. van den Bosch, and D. D. Richman,
1990. "Synthesis and antiretroviral activity of phospholipid analogs of azidothymidine
and other antiviral nucleosides." J. Biol. Chem. 265:61127.
[0311] Nonlimiting examples of U.S. patents that disclose suitable lipophilic substituents
that can be covalently incorporated into the nucleoside or other hydroxyl or amine
containing compound, preferably at the 5'-OH position of the nucleoside or lipophilic
preparations, include
U.S. Pat. No. 5,149,794 (Sep. 22, 1992, Yatvin et al.);
U.S. Pat. No. 5,194,654 (Mar. 16, 1993, Hostetler et al.,
U.S. Pat. No. 5,223,263 (Jun. 29, 1993, Hostetler et al.);
U.S. Pat. No. 5,256,641 (Oct. 26, 1993, Yatvin et al.);
U.S. Pat. No. 5,411,947 (May 2, 1995, Hostetler et al.);
U.S. Pat. No. 5,463,092 (Oct. 31, 1995, Hostetler et al.);
U.S. Pat. No. 5,543,389 (Aug. 6, 1996, Yatvin et al.);
U.S. Pat. No. 5,543,390 (Aug. 6, 1996, Yatvin et al.);
U.S. Pat. No. 5,543,391 (Aug. 6, 1996, Yatvin et al.); and
U.S. Pat. No. 5,554,728 (Sep. 10, 1996; Basava et-al.), Foreign patent applications that disclose lipophilic substituents that can be attached
to the nucleosides of the present invention, or lipophilic preparations, include
WO 89/02733,
WO 90/00555,
WO 91/16920,
WO 91/18914,
WO 93/00910,
WO 94/26273,
WO 96/15132,
EP 0 350 287,
EP 93917054.4, and
WO 91/19721.
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VI. Methods of Treatment
[0314] The compositions described herein can be used to treat patients infected with HIV-1
and HIV-2, to prevent an infection by HIV-1 and HIV-2, or to eradicate an HIV-1 or
HIV-2 infection.
[0315] When the treatment involves co-administration of the JAK inhibitors described herein
and nucleoside antiviral agents and/or non-thymidine nucleoside antiviral agents,
the HIV-1 or HIV-2 may already have developed one or more mutations, such as the M184V,
K65R mutation or TAMS. In such a case, the second agent will ideally be selected to
be active against HIV-1 or HIV-2 that has these mutations. Methods for selecting appropriate
antiretroviral therapy for patients with various mutations in their HIV-1 or HIV-2
are known to those of skill in the art.
[0316] When the treatment involves the co-administration of an adenine, cytosine, thymidine,
and guanine nucleoside antiviral agent, as well as the additional antiviral agent(s),
ideally the administration is to a patient who has not yet developed any resistance
to these antiviral agents or has been off therapy for at least three months. In that
case, it may be possible to actually cure an infected patient if the therapy can treat
substantially all of the virus, substantially everywhere it resides in the patient.
However, even in the case of infection by a resistant virus, the combination therapy
should be effective against all known resistant viral strains, because there is at
least one agent capable of inhibiting such a virus in this combination therapy, and
because the JAK inhibitors do not function in the same manner as the conventional
NRTI, NNRTI, protease inhibitors, entry inhibitors, integrase inhibitors, and the
like, and thus remain effective against strains that have mutated following exposure
to these agents.
[0317] The compounds can be used in different ways to treat or prevent HIV, and, in one
embodiment, to cure an HIV infection. In one embodiment, a combination of a JAK inhibitor
as described herein, a macrophage depleting agent (e.g., clodronate-loaded liposomes,
gadolinium chloride (GdCl)), plus HAART therapy is used. The strategy involves reducing
viral loads with traditional HAART and JAK inhibitor therapy. Then, macrophages are
systemically depleted (typically without discrimination for infected versus infected
macrophages). HAART and JAK inhibitor therapy would be maintained during macrophage
depletion. Then, treatment with the macrophage depleting agent is withdrawn, while
treatment with HAART and the JAK inhibitor is maintained.
[0318] In one aspect of this embodiment, HAART is then withdrawn, while JAK inhibitor therapy
is maintained, optionally while monitoring viral rebound.
[0319] In another aspect of this embodiment, both HAART and JAK inhibitor therapy are then
withdrawn, optionally while monitoring viral rebound.
[0320] In another embodiment, viral loads are reduced with traditional HAART + JAK inhibitors,
specifically one or both of Tofacitinib and Jakafi, as described herein. Then, macrophages
are systemically depleted (typically without discrimination for infected versus infected
macrophages) with Boniva or Fosamax (both of these drugs are potent macrophage depleting
agents). HAART + JAK inhibitor therapy is maintained during macrophage depletion.
Then, treatment with the macrophage depleting agent is withdrawn, while treatment
with HAART and the JAK inhibitor is maintained.
[0321] In one aspect of this embodiment, HAART is then withdrawn, while JAK inhibitor therapy
with one or both of Tofacitinib and Jakafi is maintained, optionally while monitoring
viral rebound.
[0322] In another aspect of this embodiment, both HAART and JAK inhibitor therapy with one
or both of Tofacitinib and Jakafi are then withdrawn, optionally while monitoring
viral rebound.
[0323] In another embodiment, a combination of a histone deacetylase inhibitor (HDAC inhibitor)
or interleukin 7 (IL-7) and HAART and a JAK inhibitor is used. One limitation associated
with treating HIV is that while it is not fully understood how HIV-1 evades the immune
response and establishes latency in resting cells, it is believed that a variety of
signalling molecules and transcription factors appear to play a role, and thus offer
potential targets for intervention. Thus, in this embodiment, IL-7 is used to confer
reactivation of resting cells, effectively flushing HIV-1 out of hiding, and histone
deacetylase (HDAC) inhibitors are used to confer reactivation by up regulation of
pro-HIV genes, effectively coaxing virus out from previously resting cells. In this
manner, latent HIV is eradicated. An example of a reactivation agent that could be
used in this manner is panobinostate, which is described, for example, in
Lewin, et al., "HIV cure and eradication: how will we get from the laboratory to effective
clinical trials?" AIDS:24 April 2011. Representative HDAC inhibitors include Vorinostat, Romidepsin (trade name Istodax),
Panobinostat (LBH589), Valproic acid (including Mg valproate and other salt forms),
Belinostat (PXD101), Mocetinostat (MGCD0103), PCI-24781, Entinostat (MS-275), SB939,
Resminostat (4SC-201), Givinostat (ITF2357), CUDC-101, AR-42, CHR-2845, CHR-3996,
4SC-202, sulforaphane, suberoylanilide hydroxamic acid (SAHA), BML-210, M344, CI-994,;
CI-994 (Tacedinaline); BML-210; M344; MGCD0103 (Mocetinostat); and Tubastatin A. Additional
HDAC inhibitors are described in
U.S. Patent No. 7,399,787.
[0324] The strategy involves reducing viral loads with traditional HAART and JAK inhibitor
therapy. Then, the patient is treated with a reactivation agent (as defined in Lewin
et al.,
supra), such as panobinostat.
[0325] In one aspect of this embodiment, both HAART and JAK inhibitor therapy are maintained
during reactivation, and in another aspect of this embodiment, HAART, but not JAK
inhibitor therapy, is maintained during reactivation.
[0326] Treatment with the reactivation agent is then withdrawn, while continuing treatment
with HAART and one or more JAK inhibitors, such as Tofacitinib and Jakafi as defined
herein.
[0327] In one aspect of this embodiment, HAART is then withdrawn, while JAK inhibitor therapy
is maintained, optionally while monitoring viral rebound.
[0328] In another aspect of this embodiment, both HAART and JAK inhibitor therapy are then
withdrawn, optionally while monitoring viral rebound.
[0329] In another embodiment, the JAK inhibitors are administered to a patient before, during,
or after administration of a vaccine and/or an immunostimulant. The use of immunostimulants
can provide an optimal antiretroviral regimen. The immunostimulatory treatments include,
but are not limited to, therapies from two functional classes: 1) agents that target
actively replicating cells and 2) agents activating latently infected cells.
[0330] In addition to the JAK inhibitors and immunomodulatory agents, HAART can also be
provided. The JAK inhibitors, optionally with co-administered HAART, can suppress
virus to undetectable or virtually undetectable levels. The addition of an immunomodulatory
therapy that specifically targets viral reservoirs can, ideally, lead to a cure, or
at least remove virus from one or more viral reservoirs.
Immunostimulants
[0331] The term "immunostimulant" is used herein to describe a substance which evokes, increases
and/or prolongs an immune response to an antigen. While the present application distinguishes
between an "antigen" and an "immunostimulant" it should be noted that this is merely
for reasons of clarity and ease of description. It should be understood that the immunostimulant
could have, and in many cases preferably has, antigenic potential itself.
[0332] Immunomodulatory agents modulate the immune system, and, as used herein, immunostimulants
are also referred to as immunomodulatory agents, where it is understood that the desired
modulation is to stimulate the immune system.
[0333] There are two main categories of immunostimulants, specific and non-specific. Specific
immunostimulants provide antigenic specificity in immune response, such as vaccines
or any antigen, and non-specific immunostimulants act irrespective of antigenic specificity
to augment immune response of other antigen or stimulate components of the immune
system without antigenic specificity, such as adjuvants and non-specific immunostimulators.
[0334] Examples of immunostimulants include levamisole, thalidomide, erythema nodosum leprosum,
BCG, cytokines such as interleukins or interferons, including recombinant cytokines
and interleukin 2 (aldeslukin), 3D-MPL, QS21, CpG ODN 7909, miltefosine, anti-PD-1
or PD-1 targeting drugs, and acid (DCA, a macrophage stimulator), imiquimod and resiquimod
(which activate immune cells through the toll-like receptor 7), chlorooxygen compounds
such as tetrachlorodecaoxide (TCDO), agonistic CD40 antibodies, soluble CD40L, 4-1BB:4-1BBL
agonists, OX40 agonists, TLR agonists, moieties that deplete regulatory T cells, arabinitol-ceramide,
glycerol-ceramide, 6-deoxy and 6-sulfono-myo-insitolceramide, iNKT agonists, TLR agonists.
[0335] WF 10 [Immunokine, Macrokine] is a 1:10 dilution of tetrachlorodecaoxide (TCDO) formulated
for intravenous injection. WF 10 specifically targets macrophages, and modulates disease-related
up-regulation of immune responses
in vivo.
[0336] 3D-MPL is an immunostimulant derived from the lipopolysaccharide (LPS) of the Gram-negative
bacterium Salmonella minnesota. MPL has been deacylated and is lacking a phosphate
group on the lipid A moiety. This chemical treatment dramatically reduces toxicity
while preserving the immunostimulant properties (Ribi, 1986). Ribi Immunochemistry
produces and supplies MPL to GSK-Biologicals.
[0337] QS21: is a natural saponin molecule extracted from the bark of the South American
tree Quillaja saponaria Molina. A purification technique developed to separate the
individual saponins from the crude extracts of the bark, permitted the isolation of
the particular saponin, QS21, which is a triterpene glycoside demonstrating stronger
adjuvant activity and lower toxicity as compared with the parent component. QS21 has
been shown to activate MHC class I restricted CTLs to several subunit Ags, as well
as to stimulate Ag specific lymphocytic proliferation (Kensil, 1992). Aquila (formally
Cambridge Biotech Corporation) produces and supplies QS21 to GSK-Biologicals.
[0338] CpG ODN 7909 is a synthetic single-stranded phosphorothioate oligodeoxynucleotide
(ODN) of 24 bases length. Its base sequence, which is 5'-TCGTCGTTTTG-TCGTTTTGTCGTT-3',
has been optimized for stimulation of the human immune system. CpG DNA or synthetic
ODN containing CpG motifs are known to activate dendritic cells, monocytes and macrophages
to secrete TH1-like cytokines and to induce TH1 T cell responses including the generation
of cytolytic T cells, stimulate NK cells to secrete IFNg and increase their lytic
activity, they also activate B cells to proliferate (
Krieg A et al. 1995 Nature 374: 546,
Chu R et al. 1997 J. Exp. Med. 186: 1623). CpG 7909 is not antisense to any known sequence of the human genome. CpG 7909 is
a proprietary adjuvant developed by and produced on behalf of Coley Pharmaceutical
Group, Inc., Mass., US.
iNKT Agonists
[0339] A subset of T cells known as iNKT (invariant natural killer T) cells are defined
by their expression of a restricted TCR repertoire, consisting of a canonical V-alpha-14-J-alpha-18
or V-alpha-24-J-alpha-18-alpha chain in mice and humans respectively. iNKT cells recognize
and become activated in response to self or foreign antigenic lipids presented by
non-polymorphic CD1d molecules expressed on the surface of APCs. iNKT cells are activated
in response to a variety of infections, and during inflammatory and autoimmune diseases.
iNKT cells provide a means of linking and coordinating innate and adaptive immune
responses, as their stimulation can induce the downstream activation of DCs, NK cells,
B and T cells. It has been demonstrated
in vitro that iNKT cells stimulate B cell proliferation and antibody production.
[0340] NKT cells can be activated by alpha-galactosyl-ceramide (alpha-GalCer) or its synthetic
analog KRN 7000 (
U.S. 2003/0157135). Alpha-GalCer can stimulate NK activity and cytokine production by NKT cells (
U.S. 2003/0157135). Alpha-GalCer and related glycosylceramides not only function as antigens, but can
also be used as soluble adjuvants capable of enhancing and/or extending the duration
of the protective immune responses induced by other antigens.
[0341] Thus, in some embodiments of the present invention the immunostimulant may be an
iNKT cell agonist. The agonist may be an exogenous or endogenous agonist. It may be
a glycosidic agonist (such as alpha-galactasylceramide) or a non-glycosidic agonist
(such as threitolceramide).
Immunostimulatory Lipids or Glycolipids
[0342] In some embodiments, the immunostimulant may be a lipid or a glycolipid. Glycolipids
presented by CD1 can be grouped into different classes including for example diacylglycerolipids,
sphingolipids, mycolates and phosphomycoketides (
Zajonc and Krenenberg, Current Opinion in Structural Biology, 2007, 17:521-529). Microbial antigens from pathogenic mycobacteria, such as glucose monomycolates
(GMM), mannosyl phosphomycoketides and phosphatidylinositol mannosides are known to
be potent ligands for human T cells when presented by group I CD1 molecules (Zajonc
an Kronenberg, supra). The immunostimulant can be a glycosylceramide, for example
alpha-galactosylceramide (KRN 7000,
US2003/0157135) or an analogue thereof, such as for example threitolceramide (IMM47) or other non-glycosidic
iNKT cell agonists (as described in
Silk et al. Cutting Edge J. Immunol, 2008). Further analogues which may be used in accordance with the invention and methods
of producing such analogues are disclosed in
WO2007/050668, which is incorporated herein by reference.
TLR Agonists
[0343] Intracellular TLRs such as TLRs 3, 7, 8 and 9 recognize nucleic acids. As such, synthetic
oligodeoxynucleotides (ODN) such as the TLR9 agonist CpG have previously been used
as immunostimulants. These TLR immunostimulants operate by a different mechanism than
that employed by lipids such as alphaGalCer. These immunostimulants directly activate
the cell that they are taken up by, culminating in, for example, the secretion of
cytokines and chemokines that result in the further stimulation of immune responses.
[0344] The TLR expression pattern is specific for each cell type (Chiron et al, 2009). TLR
expression in human B cells is characterized by high expression of TLR 1, 6, 7, 9
and 10, with the expression pattern varying during B-cell differentiation.
[0345] Soluble CpG ODNs are rapidly internalized by immune cells and interact with TLR9
that is present in endocytic vesicles. Cellular activation by most members of the
TLR family (including TLR9) involves a signaling cascade that proceeds through myeloid
differentiation primary response gene 88 (MYD88), interleukin-1 (IL-1), receptor-activated
kinase (IRAK) and tumor-necrosis factor receptor (TNFR)-associated factor 6 (TRAF6),
and culminates in the activation of several transcription factors, including nuclear
factor-kappaB (NF-kappaB), activating protein 1 (AP1), CCAAT-enhancer binding protein
(CEBP) and cAMP-responsive element binding protein (CREB). These transcription factors
directly upregulate cytokine/chemokine gene expression. B cells and plasmacytoid dendritic
cells (pDCs) are the main human cell types that express TLR9 and respond directly
to CpG stimulation. Activation of these cells by CpG DNA initiates an immunostimulatory
cascade that culminates in the indirect maturation, differentiation and proliferation
of natural killer (NK) cells, T cells and monocytes/macrophages. Together, these cells
secrete cytokines and chemokines that create a pro-inflammatory (IL-1, IL-6, IL-18
and TNF) and T.sub.H1-biased (interferon-.gamma., IFN-.gamma., and IL-12) immune milieu
(
Klinman, 2004, Nature Reviews, 4:249).
[0346] Thus, in some embodiments the immunostimulant is a TRL agonist. For example, it is
an endosomal TLR agonist, in particular a nucleic acid, such as for example DNA, RNA
(either double or single stranded). The immunostimulant may, for example comprise
a CpG oligodeoxynucleotide or a poly-U nucleic acid.
Saponins
[0348] Saponins are known as adjuvants in vaccines for systemic administration. The adjuvant
and haemolytic activity of individual saponins has been extensively studied in the
art (Lacaille-Dubois and Wagner, supra). For example, Quil A (derived from the bark
of the South American tree Quillaja Saponaria Molina), and fractions thereof, are
described in
U.S. Pat. No. 5,057,540 and "
Saponins as vaccine adjuvants", Kensil, C. R., Crit Rev Ther Drug Carrier Syst, 1996,
12 (1-2): 1-55; and
EP 0 362 279 B1. Particulate structures, termed Immune Stimulating Complexes (ISCOMS), comprising
Quil A or fractions thereof, have been used in the manufacture of vaccines (
Morein, B., EP 0 109 942 B1). These structures have been reported to have adjuvant activity (
EP 0 109 942 B1;
WO 96/11711). The hemolytic saponins QS21 and QS17 (HPLC purified fractions of Quil A) have been
described as potent systemic adjuvants, and the method of their production is disclosed
in
U.S. Pat. No.5,057,540 and
EP 0 362 279 B1. Also described in these references is the use of QS7 (a non-haemolytic fraction
of Quil-A) which acts as a potent adjuvant for systemic vaccines. Use of QS21 is further
described in
Kensil et al. (1991. J. Immunology vol 146, 431-437). Combinations of QS21 and polysorbate or cyclodextrin are also known (
WO 99/10008). Particulate adjuvant systems comprising fractions of QuilA, such as QS21 and QS7
are described in
WO 96/33739 and
WO 96/11711.
Cytokines
[0350] TH-1 type cytokines, e.g., IFN-gamma, TNF-alpha, IL-2, IL-12, IL-18, etc, tend to
favor the induction of cell mediated immune responses to an administered antigen.
In contrast, high levels of Th2-type cytokines (e.g., IL4, IL-5, IL-6 and IL-10) tend
to favor the induction of humoral immune responses. Interleukin-18 (IL-18), also known
as interferon-gamma (IFNg) inducing factor, has been described as an pleotropic cytokine
with immunomodulatory effects that stimulates patient's own immune system against
disease. IL-18 has several bioactivities, including the ability to promote the differentiation
of naive CD4 T cells into Th1 cells, to stimulate natural killer (NK) cells, natural
killer T (NKT) cells, and to induce the proliferation of activated T cells, predominantly
cytotoxic T cells (CD8+ phenotype) to secrete gamma interferon (IFN-gamma) (
Okamura H. et al. 1998, Adv. Immunol. 70: 281-312). IL-18 also mediates Fas-induced tumor death, promotes the production of IL-1a and
GMCSF, and has anti-angiogenic activity. IFN-α 2a, including pegylated versions thereof
(Pegasys), can also be used. Recombinant human Interleukin-7 (r-hIL-7 / CYT107) can
also be used.
Vaccines
[0351] As used herein, "vaccine" includes all prophylactic and therapeutic vaccines. A vaccine
includes an antigen or immunogenic derivative, and an adjuvant. As used herein, the
vaccines can be any vaccine that inhibits any of the viruses described herein, including
anti-HIV vaccines which inhibit HIV through any mechanism.
[0352] Where the vaccine is an anti-HIV vaccine, it ideally inhibits or stops the HIV virion
replication cycle at any one of the following phases of the HIV virion cycle:
Phase I. Free State
Phase II. Attachment
Phase III. Penetration
Phase IV. Uncoating
Phase V. Replication
Phase VI. Assembling
Phase VII. Releasing
[0353] While many antiviral vaccines use live viruses, with respect to HIV vaccines, it
is not advisable to use live viruses, due to the risk of infection. However, it is
known that deletion of the HIV nef gene attenuates the virus. Desrosiers and his associates
have demonstrated that vaccination of macaques with nef-deleted SIV protected wild-type
SIV challenge (
Daniels, M. D. et al. Science 258:1938 (1992);
Desrosiers, R. C., et al. Proc. Natl. Acad. Sci. USA 86:6353 (1989)) and others have demonstrated that nef gene is dispensable for SIV and HIV replication
(
Daniels, M. D. et al. Science 258:1938 (1992);
Gibbs, J. S., et al. AIDS Res. and Human Retroviruses 10:343 (1994);
Igarashi, T., et al. J. Gen. Virol. 78:985 (1997);
Kestler III, H. W., et al. Cell 65:651 (1991)). Furthermore, deletion of nef gene renders the virus to be non-pathogenic in the
normally susceptible host (
Daniels, M. D. e t al. Science 258:1938 (1992)).
[0354] In terms of antigens, subunit vaccines can be used (
Cooney EL, et al., Proc Natl Acad Sci USA 1993; 90; 1882-86;
McElrath M J, et al. J Infect Dis. 169: 41-47 (1994);
Graham B S, et al. J Infect Dis 166: 244-52 (1992); and
Graham B S, et al. J Infect Dis 167: 533-37 (1993)). HIV-derived antigens include HIV-1 antigen gp120, tat, nef, reverse transcriptase,
gag, gp120 and gp160, and various targets in pol One examples of an HIV vaccine is
the DermaVir therapeutic HIV vaccine, currently in Phase II clinical studies.
[0355] The vaccines of the present invention may additionally contain suitable diluents,
adjuvants and/or carriers. In some embodiments, the vaccines contain an adjuvant which
can enhance the immunogenicity of the vaccine
in vivo. The adjuvant may be selected from many known adjuvants in the art, including the
lipid-A portion of gram negative bacteria endotoxin, trehalose dimycolate of mycobacteria,
the phospholipid lysolecithin, dimethyldictadecyl ammonium bromide (DDA), certain
linear polyoxypropylene-polyoxyethylene (POP-POE) block polymers, aluminum hydroxide,
and liposomes. The vaccines may also include cytokines that are known to enhance the
immune response including GM-CSF, IL-2, IL-12, TNF-α and IFNγ.
[0356] The dose of the vaccine may vary according to factors such as the disease state,
age, sex, and weight of the individual, and the ability of antibody to elicit a desired
response in the individual. Dosage regime may be adjusted to provide the optimum therapeutic
response. For example, several divided doses may be administered daily or the dose
may be proportionally reduced as indicated by the exigencies of the therapeutic situation.
The dose of the vaccine may also be varied to provide optimum preventative dose response
depending upon the circumstances.
[0357] The vaccines may be administered in a convenient manner such as by injection (subcutaneous,
intravenous, intramuscular, etc.), oral administration, inhalation, transdermal administration
(such as topical cream or ointment, etc.), or suppository applications.
Recombinant Retrovirus
[0358] The recombinant retrovirus of the present invention can be any retrovirus, including
HIV-1, HIV-2, SIV, HTLV-1. Preferably the retrovirus is a human immunodeficiency virus
selected from HIV-1 and HIV-2, more preferably, the retrovirus is HIV-1.
[0359] The vaccine can be an essentially non-cytolytic retrovirus, wherein the term "essentially
non- cytolytic" means that the retrovirus does not significantly damage or kill the
cells it infects. In one embodiment, the natural signal sequence of HIV-1 envelope
glycoprotein gp120 (NSS) is modified to be essentially non-cytolytic, or is replaced
with an essentially non-cytolytic signal sequence.
[0360] In one embodiment, the present invention provides an essentially non-cytolytic recombinant
HIV-1 capable of highly efficient replication wherein the NSS of the virus' envelope
glycoprotein is modified sufficiently to prevent cell damage by the virus, preferably
by eliminating positively charged amino acids, even more preferably, such elimination
or modification resulting in no more than one (1) and preferably zero (0) positively
charged amino acids. The positively charged amino acids which may be modified or replaced
include lysine and arginine.
[0361] In another embodiment, replacement of the natural signal sequence results in a more
efficient replication of HIV. Accordingly the present invention provides an essentially
non-cytolytic recombinant HIV-1 capable of highly efficient replication wherein the
NSS of the virus' envelope glycoprotein is replaced with an essentially non-cytolytic
and more efficient signal sequence. In a preferred embodiment, replacement of the
NSS of the envelope glycoprotein of HIV-1 with either the mellitin or IL-3 signal
sequence decreases the cytotoxicity of the retrovirus. As such, the present invention
includes within its scope replacement of NSS with any signal sequence which renders
the retrovirus essentially non-cytolytic. The inventors have also shown that replacement
of the NSS with mellitin or IL-3 signal sequences results in a greater level of production
and secretion of gp120, in addition to the reduced cytotoxicity. The inventors have
also shown that replacement of the NSS results in partial deletion the vpu gene. Studies
have shown the vpu gene can be completely deleted without any measurable impact on
the virus' ability to replicate (
James et al. AIDS Res. Human Retrovirus 10:343-350, 1994).
[0362] In another embodiment, the retrovirus is rendered avirulent. In a preferred embodiment,
the virus is rendered avirulent by deleting the nef gene. Accordingly, the present
invention provides an avirulent, essentially non-cytolytic retrovirus which contains
a sufficient deletion of the nef gene to render the virus non-pathogenic and wherein
the virus' envelope glycoprotein gp120 coding sequence is replaced with a more efficient
signal sequence. As used herein, "sufficient deletion" means deletion of enough of
the sequence to prevent transcription and thereby production of the nef protein product.
[0363] In a further embodiment, the retrovirus is rendered avirulent, essentially non-cytolytic,
and contains a sufficient deletion of the nef gene and the vpu gene to render the
virus non-pathogenic.
[0364] Recombinant retroviruses be prepared using techniques known in the art. In one embodiment,
the retrovirus can be introduced in a host cell under conditions suitable for the
replication and expression of the retrovirus in the host.
[0365] The essentially non-cytolytic and avirulent retroviruses can typically be produced
in large quantities and in a form that is non-pathogenic to the patient. The viruses
can be used, in combination with the JAK inhibitors and, optionally, with HAART, for
preventing or treating a retroviral infection. In this use, an effective amount of
a killed recombinant essentially non-cytolytic avirulent retrovirus is administered
to a patient in need of treatment or prophylaxis of a retroviral infection. The term
"effective amount" as used herein means an amount effective and at dosages and for
periods of time necessary to achieve the desired result.
[0366] In one embodiment, the natural signal sequence of the virus' envelope glycoprotein,
such as gp120, is modified to provide an essentially non-cytolytic signal sequence,
and/or the virus is rendered avirulent by deleting the nef gene. In one aspect of
this embodiment, the modification to provide a non-cytolytic NSS results in no more
than one positively charged amino acid in the NSS sequence, more preferably zero positively
charged amino acids.
[0367] In another aspect of this embodiment, the natural signal sequence of the virus' envelope
glycoprotein, preferably gp120, is replaced with an essentially non-cytolytic signal
sequence, and, optionally, the virus is rendered avirulent by deleting the nef gene.
[0368] In another aspect of this embodiment, where the NSS is replaced, the non-cytolytic
signal sequence is selected from the group consisting of the mellitin sequence and
the IL-3 signal sequence.
Chimaeric Antigens
[0369] The vaccines can comprise chimaeric antigens, for example, a chimaeric influenza-HIV
vaccine. In one embodiment, the vaccine comprises the A-antigenic loop of influenza
haemagglutinin (HA-A), modified to resemble the principle neutralizing determinant
(PND) of HIV envelope glycoprotein gp120. The Chimaeric antigens can be presented
as killed or attenuated virus.
Vaccine Production
[0370] To produce a vaccine, the antigen is typically combined with a pharmaceutically acceptable
carrier, and, typically, an adjuvant, to make a composition comprising a vaccine.
This vaccine composition is optionally combined with an immunostimulant and administered
to a patient in need of treatment or prevention of a viral infection.
[0371] In one embodiment, the vaccine includes antigens selected for more than one virus,
particularly where co-infection rates are known to be high. One example is HIV and
HBV or HCV, or HIV and influenza.
[0372] A variety of adjuvants known to one of ordinary skill in the art may be administered
in conjunction with the protein in the vaccine composition. Such adjuvants include,
but are not limited to the following: polymers, co-polymers such as polyoxyethylene-polyoxypropylene
copolymers, including block co-polymers; polymer P1005; monotide ISA72; Freund's complete
adjuvant (for animals); Freund's incomplete adjuvant; sorbitan monooleate; squalene;
CRL-8300 adjuvant; alum; QS 21, muramyl dipeptide; trehalose; bacterial extracts,
including mycobacterial extracts; detoxified endotoxins; membrane lipids; or combinations
thereof.
[0373] The vaccine formulations can be presented in unit dosage form, and can be prepared
by conventional pharmaceutical techniques. Such techniques include the step of bringing
into association the active ingredient and the pharmaceutical carrier(s) or excipient(s).
In general, the formulations are prepared by uniformly and intimately bringing into
association the active ingredient with liquid carriers. Formulations suitable for
parenteral administration include aqueous and non-aqueous sterile injection solutions
which may contain anti-oxidants, buffers, bacteriostats and solutes which render the
formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous
sterile suspensions which may include suspending agents and thickening agents. The
formulations may be presented in unit-dose or multi-dose containers, for example,
sealed ampules and vials, and may be stored in a freeze-dried (lyophilized) condition
requiring only the addition of the sterile liquid carrier, for example, water for
injections, immediately prior to use. Extemporaneous injection solutions and suspensions
may be prepared from sterile powders, granules and tablets commonly used by one of
ordinary skill in the art.
[0374] Preferred unit dosage formulations are those containing a dose or unit, or an appropriate
fraction thereof, of the administered ingredient. It should be understood that in
addition to the ingredients, particularly mentioned above, the formulations of the
present invention may include other agents commonly used by one of ordinary skill
in the art.
[0375] The vaccine may be administered through different routes, such as oral, including
buccal and sublingual, rectal, parenteral, aerosol, nasal, intramuscular, subcutaneous,
intradermal, and topical. The vaccine of the present invention may be administered
in different forms, including but not limited to solutions, emulsions and suspensions,
microspheres, particles, microparticles, nanoparticles, and liposomes. It is expected
that from about 1 to 5 dosages may be required per immunization regimen. Initial injections
may range from about 1 mg to 1 gram, with a preferred range of about 10 mg to 800
mg, and a more preferred range of from approximately 25 mg to 500 mg. Booster injections
may range from 1 mg to 1 gram, with a preferred range of approximately 10 mg to 750
mg, and a more preferred range of about 50 mg to 500 mg.
[0376] The volume of administration will vary depending on the route of administration.
Intramuscular injections may range from about 0.1 ml to 1.0 ml.
[0377] The vaccines can be administered before, during or after an infection. An infected
individual can receive a vaccine directed to the virus infecting the individual, even
though the levels are reduced via treatment with the JAK inhibitors and/or HAART,
stimulating the immune system to fight the virus that remains in the individual.
[0378] The vaccine may be stored at temperatures of from about 4C. to -100C. The vaccine
may also be stored in a lyophilized state at different temperatures including room
temperature. The vaccine may be sterilized through conventional means known to one
of ordinary skill in the art. Such means include, but are not limited to filtration,
radiation and heat. The vaccine of the present invention may also be combined with
bacteriostatic agents, such as thimerosal, to inhibit bacterial growth.
Treatment or Prevention of Other Viral Infections
[0379] The invention includes methods for treating or preventing, and uses for the treatment
or prophylaxis, of a
Flaviviridae infection, including all members of the Hepacivirus genus (HCV), Pestivirus genus
(BVDV, CSFV, BDV), or Flavivirus genus (Dengue virus, Japanese encephalitis virus
group (including West Nile Virus), and Yellow Fever virus).
Viruses Characterized by the Flaviviridae Family
[0380] The Flaviviridae is a group of positive single-stranded RNA viruses with a genome
size from 9-15 kb. They are enveloped viruses of approximately 40-50 nm. An overview
of the Flaviviridae taxonomy is available from the International Committee for Taxonomy
of Viruses. The Flaviviridae consists of three genera.
[0381] Flaviviruses. This genus includes the Dengue virus group (Dengue virus, Dengue virus type 1, Dengue
virus type 2, Dengue virus type 3, Dengue virus type 4), the Japanese encephalitis
virus group (Alfuy Virus, Japanese encephalitis virus, Kookaburra virus, Koutango
virus, Kunjin virus, Murray Valley encephalitis virus, St. Louis encephalitis virus,
Stratford virus, Usutu virus, West Nile Virus), the Modoc virus group, the Rio Bravo
virus group (Apoi virus, Rio Brovo virus, Saboya virus), the Ntaya virus group, the
Tick-Borne encephalitis group (tick born encephalitis virus), the Tyuleniy virus group,
Uganda S virus group and the Yellow Fever virus group. Apart from these major groups,
there are some additional Flaviviruses that are unclassified.
[0382] Pestiviruses. This genus includes Bovine Viral Diarrhea Virus-2 (BVDV-2), Pestivirus type 1 (including
BVDV), Pestivirus type 2 (including Hog Cholera Virus) and Pestivirus type 3 (including
Border Disease Virus).
[0383] Hepaciviruses. This genus contains only one species, the Hepatitis C virus (HCV), which is composed
of many clades, types and subtypes.
[0384] Chikungunya virus, an RNA virus of the genus Alphavirus, can also be treated using
the compounds described herein.
[0385] Those of skill in the art can effectively follow the administration of these therapies,
and the development of side effects and/or resistant viral strains, without undue
experimentation.
[0386] The present invention will be better understood with reference to the following non-limiting
examples.
Example 1: Comparison of JAK Inhibitors to Conventional Antiretroviral Therapy
[0387] Current first line highly active antiretroviral therapy (HAART) for the treatment
of human immunodeficiency virus (HIV-1) infections combines two nucleoside reverse
transcriptase inhibitors (NRTI) together with either a protease inhibitor (PI) or
non-nucleoside reverse transcriptase inhibitor (NNRTI). These drug combinations have
markedly decreased mortality and morbidity from HIV-1 infections in the developed
world.
[0388] Existing therapies cannot eradicate HIV-1 infection because of the compartmentalization
of the virus and its latent properties. Therefore, chronic therapy remains the standard
of care for the foreseeable future. Although HAART regimens are selected in part to
minimize cross resistance, and thereby delay the emergence of resistant viruses, all
regimens eventually fail, due primarily to lack of adherence to strict regimens, delayed
toxicities and/or the emergence of drug-resistant HIV-1 strains, making it a major
imperative to develop regimens that delay, prevent or attenuate the onset of resistance
for second line treatments for infected individuals who have already demonstrated
mutations. The occurrence of common resistance mutations, including thymidine analog
mutations (TAM), K65R and M184V, need to be a continued focus in the rational design
of HIV-1 NRTI drug development.
[0389] The objectives of this study were to evaluate JAK inhibitors that do not appear to
function in the same manner as NRTI, NNRTI, protease inhibitors, entry inhibitors,
integrase inhibitors, and the like. In the data shown in this example, the JAK inhibitors
that were evaluated were Jakafi (Incyte) and Tofacitinib (Pfizer).
PBM cell and Mϕ protocol for antiviral potency
[0390] Macrophages were isolated as follows: Monocytes were isolated from buffy coats of
HIV-1 negative, HBV/HCV-negative donors with density gradient centrifugation coupled
with enrichment for CD14+ monocytes with Rosette Sep antibody cocktail (Stem Cell
Technologies, Vancouver, British Columbia). Cells were seeded at a concentration of
1.0 x 10
6 cells/well for 1 hr at 37°C and 5% CO
2 to confer plastic adherence prior to repeated washes with 1 x PBS. Macrophages were
maintained in medium containing 100 U/ml macrophage colony-stimulating factor (m-CSF,
R&D Systems, Minneapolis, MN), supplemented with 20% fetal calf serum (Atlanta Biologicals,
Lawrenceville, GA) and 1% penicillin/streptomyocin (Invitrogen, Carlsbad, CA) for
7 days (37oC, 5% CO2) prior to testing.
[0391] Macrophage infections: Macrophages were cultured as described above for 7 days. For
acute infection, macrophages were serum starved for 8 hrs prior to infection and cultured
for 2 hr in medium containing various concentrations of AZT (positive control) or
Tofacitinib and Jakafi for 2 hr prior to removal of drug-containing medium and 4 hr
infection with HIV-1BaL at 0.1 MOI in the absence of drug. 4 hrs after infection,
virus was removed and drug-containing medium was returned to the cultures. Supernatants
were collected on day 7 post-infection and HIV-1 p24 was quantified via ELISA (Zeptometrix
Corporation, Buffalo, NY). EC50 analysis was performed using CalcuSyn software (BioSoft
Corporation, Cambridge, UK).
[0392] PBM cells were isolated as follows: Lymphocytes were isolated from buffy coats derived
from healthy donors obtained from Life South Laboratories (Dunwoody, GA). Activated
lymphocytes were maintained for 72 hrs in medium that was supplemented with 6 µg/ml
phytohemagglutinin (PHA) (Cape Cod associates, East Falmouth, MA). Media was comprised
of RPMI media supplemented with 20% fetal calf serum, 1% penicillin/streptomyocin
and 2% L-glutamine (Sigma Aldrich, San Jose, CA).
[0393] PBM cell infections: Testing was performed in duplicate with at least 3 independent
assays. Cells were incubated in RPMI medium (HyClone, Logan, Utah) containing HR-IL2
(26.5 units/ml) and 20% fetal calf serum. Infections were performed by adding HIV-1
LAI followed by a further incubation at 37°C, 5% CO2, 1 hr prior to addition of drugs.
Assays were performed in 24 well plates (BD Biosciences, Franklin Lakes, New Jersey).
One ml of supernatant was collected after 5 days in culture and then centrifuged at
12,000 rpm for 2 hr at 4°C in a Jouan Br43i (Thermo Electron Corp., Marietta, OH).
The product of the RT assay was quantified using a Packard harvester and direct beta
counter and the data were analyzed as previously described (Schinazi et al, 1990).
Cytotoxicity Assay
[0394] The toxicity of the compounds was assessed in Vero, human PBM, CEM (human lymphoblastoid),
as described previously (see
Schinazi R.F., Sommadossi J.-P., Saalmann V., Cannon D.L., Xie M.-Y., Hart G.C., Smith
G.A. & Hahn E.F. Antimicrob. Agents Chemother. 1990, 34, 1061-67), and also in MØ cells. Cycloheximide was included as positive cytotoxic control,
and untreated cells exposed to cell culture medium were included as negative controls.
[0396] The potency and toxicity of JAK inhibitors Tofacitinib and Jakafi versus FDA approved
controls AZT and 3TC was evaluated in acutely infected activated MØ, as well as in
PBM cells. The EC
50 data (µM) is shown in Figure 1. Also shown in Figure 1 are the IC
50 values (µM) for these compounds in PBM, MØ cells, CEM cells, and Vero cells.
[0397] The data show a very large therapeutic window (ratio of toxicity/potency), and that
the JAK inhibitor compounds have substantially the same EC
50 and substantially lower IC
50 values as AZT and 3TC.
[0398] Cell proliferation was evaluated in activated PBM cells incubated for 5 days with
various concentrations of Tofacitinib and Jakafi, with cycloheximide as a positive
control, and a "cells plus media" control used as well. The data is shown in Figure
2, in terms of total cell number (10
6 cells) versus µM drug in medium. The data shows that Tofacitinib and Jakafi do not
affect total cell proliferation at antiviral concentrations.
[0399] Cell viability was evaluated in activated PBM cells incubated for 5 days with various
concentrations of Tofacitinib and Jakafi, with cycloheximide as a positive control,
and a "cells plus media" control used as well. The data is shown in Figure 3, in terms
of cell viability (%) versus µM drug in medium. The data shows that Tofacitinib and
Jakafi do not affect total cell viability at antiviral concentrations.
Conclusion
[0400] In conclusion, Tofacitinib and Jakafi are potent, sub-micromolar inhibitors of HIV-1
replication in both PBM cells and MØ cells. The compounds do not affect viability
or proliferation for PBM cells and MØ cells, or total cell number, up to around 10
µM (2-3 logs above EC
50). The therapeutic window (ratio of toxicity:potency) is wide for both cell types
(24- >100).
Example 2: Mitochondrial Toxicity Assays in HepG2 Cells:
[0401]
- i) Effect of the JAK Inhibitors described herein on Cell Growth and Lactic Acid Production: The effect on the growth of HepG2 cells can be determined by incubating cells in
the presence of 0 µM, 0.1 µM, 1 µM, 10 µM and 100 µM drug. Cells (5 x 104 per well) were plated into 12-well cell culture clusters in minimum essential medium
with nonessential amino acids supplemented with 10% fetal bovine serum, 1% sodium
pyruvate, and 1% penicillin/streptomycin and incubated for 4 days at 37°C. At the
end of the incubation period the cell number was determined using a hemocytometer.
Also taught by Pan-Zhou X-R, Cui L, Zhou X-J, Sommadossi J-P, Darley-Usmer VM "Differential effects
of antiretroviral nucleoside analogs on mitochondrial function in HepG2 cells"Antimicrob.
Agents Chemother. 2000; 44: 496-503. To measure the effects of the compounds on lactic acid production, HepG2 cells from
a stock culture can be diluted and plated in 12-well culture plates at 2.5 x 104 cells per well. Various concentrations (0 µM, 0.1 µM, 1 µM, 10 µM and 100 µM) of
the compounds can be added, and the cultures incubated at 37°C in a humidified 5%
CO2 atmosphere for 4 days. At day 4 the number of cells in each well can be determined
and the culture medium collected. The culture medium was filtered, and the lactic
acid content in the medium determined using a colorimetric lactic acid assay (Sigma-Aldrich).
Since lactic acid product can be considered a marker for impaired mitochondrial function,
elevated levels of lactic acid production detected in cells grown in the presence
of the compounds would indicate a drug-induced cytotoxic effect.
- ii) Effect on the compounds on Mitochondrial DNA Synthesis: a real-time PCR assay to accurately quantify mitochondrial DNA content has been developed
(see Stuyver LJ, Lostia S, Adams M, Mathew JS, Pai BS, Grier J, Tharnish PM, Choi Y, Chong
Y, Choo H, Chu CK, Otto MJ, Schinazi RF. Antiviral activities and cellular toxicities
of modified 2',3'-dideoxy-2',3'-didehydrocytidine analogs. Antimicrob. Agents Chemother.
2002; 46: 3854-60). This assay can be used to determine the effect of the compounds on mitochondrial
DNA content. In this assay, low-passage-number HepG2 cells are seeded at 5,000 cells/well
in collagen-coated 96-well plates. The compounds are added to the medium to obtain
final concentrations of 0 µM, 0.1 µM, 10 µM and 100 µM. On culture day 7, cellular
nucleic acids are prepared by using commercially available columns (RNeasy 96 kit;
Qiagen). These kits co-purify RNA and DNA, and hence, total nucleic acids were eluted
from the columns. The mitochondrial cytochrome c oxidase subunit II (COXII) gene and
the β-actin or rRNA gene were amplified from 5 µl of the eluted nucleic acids using
a multiplex Q-PCR protocol with suitable primers and probes for both target and reference
amplifications. For COXII the following sense, probe and antisense primers are used,
respectively: 5'-TGCCCGCCATCATCCTA-3', 5'-tetrachloro-6-carboxyfluorescein-TCCTCATCGCCCTCCCATCCC-TAMRA-3'
and 5'-CGTCTGTTATGTAAAGGATGCGT-3'. For exon 3 of the β-actin gene (GenBank accession
number E01094) the sense, probe, and antisense primers are 5'-GCGCGGCTACAGCTTCA-3',
5'-6-FAMCACCACGGCCGAGCGGGATAMRA-3' and 5'-TCTCCTTAATGTCACGCACGAT-3', respectively.
The primers and probes for the rRNA gene are commercially available from Applied Biosystems.
Since equal amplification efficiencies are obtained for all genes, the comparative
CT method can be used to investigate potential inhibition of mitochondrial DNA synthesis.
The comparative CT method uses arithmetic formulas in which the amount of target (COXII gene) is normalized
to the amount of an endogenous reference (the β-actin or rRNA gene) and is relative
to a calibrator (a control with no drug at day 7). The arithmetic formula for this
approach is given by 2-ΔΔCT, where ΔΔCT is (CT for average target test sample - CT for target control) - (CT for average reference test -CT for reference control) (see Johnson MR, K Wang, JB Smith, MJ Heslin, RB Diasio. Quantitation of dihydropyrimidine
dehydrogenase expression by real-time reverse transcription polymerase chain reaction.
Anal. Biochem. 2000; 278:175-184). A decrease in mitochondrial DNA content in cells grown in the presence of drug
would indicate mitochondrial toxicity.
- iii) Electron Microscopic Morphologic Evaluation: NRTI induced toxicity has been shown to cause morphological changes in mitochondria
(e.g., loss of cristae, matrix dissolution and swelling, and lipid droplet formation)
that can be observed with ultrastructural analysis using transmission electron microscopy
(see Cui L, Schinazi RF, Gosselin G, Imbach JL. Chu CK, Rando RF, Revankar GR, Sommadossi
JP. Effect of enantiomeric and racemic nucleoside analogs on mitochondrial functions
in HepG2 cells. Biochem. Pharmacol. 1996, 52, 1577-1584; Lewis W, Levine ES, Griniuviene B, Tankersley KO, Colacino JM, Sommadossi JP, Watanabe
KA, Perrino FW. Fialuridine and its metabolites inhibit DNA polymerase gamma at sites
of multiple adjacent analog incorporation, decrease mtDNA abundance, and cause mitochondrial
structural defects in cultured hepatoblasts. Proc Natl Acad Sci U S A. 1996; 93: 3592-7; Pan-Zhou XR, L Cui, XJ Zhou, JP Sommadossi, VM Darley-Usmar. Differential effects
of antiretroviral nucleoside analogs on mitochondrial function in HepG2 cells. Antimicrob.
Agents Chemother. 2000, 44, 496-503). For example, electron micrographs of HepG2 cells incubated with 10 µM fialuridine
(FIAU; 1,2'-deoxy-2'-fluoro-1-D-arabinofuranosly-5-iodo-uracil) showed the presence
of enlarged mitochondria with morphological changes consistent with mitochondrial
dysfunction. To determine if the JAK inhibitor compounds promote morphological changes
in mitochondria, HepG2 cells (2.5 x 104 cells/mL) can be seeded into tissue cultures dishes (35 by 10 mm) in the presence
of 0 µM, 0.1 µM, 1 µM, 10 µM and 100 µM nucleoside analog. At day 8, the cells can
be fixed, dehydrated, and embedded in Eponas described previously. Thin sections can
be prepared, stained with uranyl acetate and lead citrate, and then examined using
transmission electron microscopy.
Example 3: Mitochondrial Toxicity Assays in Neuro2A Cells
[0402] To estimate the potential of the JAK inhibitor compounds to cause neuronal toxicity,
mouse Neuro2A cells (American Type Culture Collection 131) can be used as a model
system (see
Ray AS, Hernandez-Santiago BI, Mathew JS, Murakami E, Bozeman C, Xie MY, Dutschman
GE, Gullen E, Yang Z, Hurwitz S, Cheng YC, Chu CK, McClure H, Schinazi RF, Anderson
KS. Mechanism of anti-human immunodeficiency virus activity of beta-D-6-cyclopropylamino-2',3'-didehydro-2',3'-dideoxyguanosine.
Antimicrob. Agents Chemother. 2005, 49, 1994-2001). The concentrations necessary to inhibit cell growth by 50% (CC
50) can be measured using the 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium
bromide dye-based assay, as described. Perturbations in cellular lactic acid and mitochondrial
DNA levels at defined concentrations of drug can be carried out as described above.
Example 4: Assay for Bone Marrow Cytotoxicity
[0403] Primary human bone marrow mononuclear cells were obtained commercially from Cambrex
Bioscience (Walkersville, MD). CFU-GM assays can be carried out using a bilayer soft
agar in the presence of 50 units/mL human recombinant granulocyte/macrophage colony-stimulating
factor, while BFU-E assays used a methylcellulose matrix containing 1 unit/mL erythropoietin
(see
Sommadossi JP, Carlisle R. Toxicity of 3'-azido-3'-deoxythymidine and 9-(1,3-dihydroxy-2-propoxymethyl)
guanine for normal human hepatopoietic progenitor cells in vitro. Antimicrob. Agents
Chemother. 1987; 31: 452-454;
Sommadossi, JP, Schinazi, RF, Chu, CK, and Xie, MY. Comparison of Cytotoxicity of
the (-) and (+) enantiomer of 2',3'-dideoxy-3'-thiacytidine in normal human bone marrow
progenitor cells. Biochem. Pharmacol. 1992; 44:1921-1925). Each experiment can be performed in duplicate in cells from three different donors.
AZT can be used as a positive control. Cells can be incubated in the presence of a
JAK inhibitor compound for 14-18 days at 37°C with 5% CO
2, and colonies of greater than 50 cells can be counted using an inverted microscope
to determine IC
50. The 50% inhibitory concentration (IC
50) can be obtained by least-squares linear regression analysis of the logarithm of
drug concentration versus BFU-E survival fractions. Statistical analysis can be performed
with Student's
t test for independent non-paired samples.
Example 5: Anti-HBV Assay
[0404] The anti-HBV activity of the JAK inhibitor compounds can be determined by treating
the AD-38 cell line carrying wild type HBV under the control of tetracycline (see
Ladner S.K., Otto M.J., Barker C.S., Zaifert K., Wang G.H., Guo J.T., Seeger C. &
King R.W. Antimicrob. Agents Chemother. 1997, 41, 1715-20). Removal of tetracycline from the medium [Tet (-)] results in the production of
HBV. The levels of HBV in the culture supernatant fluids from cells treated with the
compounds can be compared with that of the untreated controls. Control cultures with
tetracycline [Tet (+)] can also be maintained to determine the basal levels of HBV
expression. 3TC can be included as positive control.
Example 6: Cytotoxicity Assay
[0405] The toxicity of the compounds can be assessed in Vero, human PBM, CEM (human lymphoblastoid),
MT-2, and HepG2 cells, as described previously (see
Schinazi R.F., Sommadossi J.-P., Saalmann V., Cannon D.L., Xie M.-Y., Hart G.C., Smith
G.A. & Hahn E.F. Antimicrob. Agents Chemother. 1990, 34, 1061-67). Cycloheximide can be included as positive cytotoxic control, and untreated cells
exposed to solvent can be included as negative controls. The cytotoxicity IC
50 can be obtained from the concentration-response curve using the median effective
method described previously (see
Chou T.-C. & Talalay P. Adv. Enzyme Regul. 1984, 22, 27-55;
Belen'kii M.S. & Schinazi R.F. Antiviral Res. 1994, 25, 1-11).
Example 7: HCV Replicon Assay1
[0406] Huh 7 Clone B cells containing HCV Replicon RNA can be seeded in a 96-well plate
at 5000 cells/well, and the JAK inhibitor compounds tested at 10 µM in triplicate
immediately after seeding. Following five days incubation (37°C, 5% CO
2), total cellular RNA can be isolated by using versaGene RNA purification kit from
Gentra. Replicon RNA and an internal control (TaqMan rRNA control reagents, Applied
Biosystems) can be amplified in a single step multiplex Real Time RT-PCR Assay. The
antiviral effectiveness of the compounds can be calculated by subtracting the threshold
RT-PCR cycle of the test compound from the threshold RT-PCR cycle of the no-drug control
(ΔCt HCV). A ΔCt of 3.3 equals a 1-log reduction (equal to 90% less starting material)
in Replicon RNA levels. The cytotoxicity of the compounds can also be calculated by
using the ΔCt rRNA values. (2'-Me-
C) can be used as the control. To determine EC
90 and IC
50 values
2, ΔCt: values can first be converted into fraction of starting material
3 and then were used to calculate the
% inhibition.
References:
Example 8: Assay for Effectiveness Against West Nile Virus
[0408] West Nile virus drug susceptibility assays can also be done as previously described
in:
Song, G.Y., Paul, V., Choo, H., Morrey, J., Sidwell, R.W., Schinazi, R.F., Chu, C.K.
Enantiomeric synthesis of D- and L-cyclopentenyl nucleosides and their antiviral activity
against HIV and West Nile virus. J. Med. Chem. 2001, 44, 3985-3993.
Example 9: Assay for Effectiveness Against Yellow Fever
Example 10: Assay for Effectiveness Against Dengue
[0411] Dengue virus (DENV) NS5 possesses methyltransferase (MTase) activity at its N-terminal
amino acid sequence and is responsible for formation of a type 1 cap structure, m7GpppAm2'-O
in the viral genomic RNA. Optimal
in vitro conditions for DENV2 2'-O-MTase activity can be characterized using purified recombinant
protein and a short biotinylated GTP-capped RNA template. Steady-state kinetics parameters
derived from initial velocities can be used to establish a robust scintillation proximity
assay for compound testing. Pre-incubation studies by
Lim et al., Antiviral Research, Volume 80, Issue 3, December 2008, Pages 360-369, showed that MTase-AdoMet and MTase-RNA complexes were equally catalytically competent
and the enzyme supports a random bi bi kinetic mechanism. Lim validated the assay
with competitive inhibitory agents, S-adenosyl-homocysteine and two homologues, sinefungin
and dehydrosinefungin. A GTP-binding pocket present at the N-terminal of DENV2 MTase
was previously postulated to be the cap-binding site. This assay allows rapid and
highly sensitive detection of 2'-O-MTase activity and can be readily adapted for high-throughput
screening for inhibitory compounds. It is suitable for determination of enzymatic
activities of a wide variety of RNA capping MTases.
Example 11. Anti-Norovirus Activity
[0412] Compounds can exhibit anti-norovirus activity by inhibiting norovirus polymerase
and/or helicase, by inhibiting other enzymes needed in the replication cycle, or by
other pathways.
[0413] There is currently no approved pharmaceutical treatment for Norovirus infection (http://www.cdc.gov/ncidod/dvrd/revb/gastro/norovirus-qa.htm),
and this has probably at least in part been due to the lack of availability of a cell
culture system. Recently, a replicon system has been developed for the original Norwalk
G-I strain (
Chang, K. O., et al. (2006) Virology 353:463-473)
[0414] Both Norovirus replicons and Hepatitis C replicons require viral helicase, protease,
and polymerase to be functional in order for replication of the replicon to occur.
Most recently, an
in vitro cell culture infectivity assay has been reported utilizing Norovirus genogroup I
and II inoculums (
Straub, T. M. et al. (2007) Emerg. Infect. Dis. 13(3):396-403). This assay is performed in a rotating-wall bioreactor utilizing small intestinal
epithelial cells on microcarrier beads. The infectivity assay may be useful for screening
entry inhibitors.
Example 12: Bioavailability Assay in Cynomolgus Monkeys
[0415] The following procedure can be used to determine whether the compounds are bioavailable.
Within 1 week prior to the study initiation, a cynomolgus monkey can be surgically
implanted with a chronic venous catheter and subcutaneous venous access port (VAP)
to facilitate blood collection and can undergo a physical examination including hematology
and serum chemistry evaluations and the body weight recording. Each monkey (six total)
receives approximately 250 µCi of
3H activity with each dose of active compound at a dose level of 10 mg/kg at a dose
concentration of 5 mg/mL, either via an intravenous bolus (3 monkeys, IV), or via
oral gavage (3 monkeys, PO). Each dosing syringe is weighed before dosing to gravimetrically
determine the quantity of formulation administered. Urine samples are collected via
pan catch at the designated intervals (approximately 18-0 hours pre-dose, 0-4, 4-8
and 8-12 hours post-dosage) and processed. Blood samples are collected as well (pre-dose,
0.25, 0.5, 1,2, 3,6, 8, 12 and 24 hours post-dosage) via the chronic venous catheter
and VAP or from a peripheral vessel if the chronic venous catheter procedure should
not be possible. The blood and urine samples are analyzed for the maximum concentration
(Cmax), time when the maximum concentration is achieved (TmaX), area under the curve
(AUC), half life of the dosage concentration (TV,), clearance (CL), steady state volume
and distribution (Vss) and bioavailability (F).
Example 13: Cell Protection Assay (CPA)
[0416] The assay can be perforrmed essentially as described by
Baginski, S. G.; Pevear, D. C.; Seipel, M.; Sun, S. C. C.; Benetatos, C. A.; Chunduru,
S. K.; Rice, C. M. and M. S. Collett "Mechanism of action of a pestivirus antiviral
compound"PNAS USA 2000, 97 (14), 7981- 7986. MDBK cells (ATCC) are seeded onto 96-well culture plates (4,000 cells per well)
24 hours before use. After infection with BVDV (strain NADL, ATCC) at a multiplicity
of infection (MOI) of 0.02 plaque forming units (PFU) per cell, serial dilutions of
test compounds are added to both infected and uninfected cells in a final concentration
of 0.5% DMSO in growth medium. Each dilution is tested in quadruplicate.
[0417] Cell densities and virus inocula are adjusted to ensure continuous cell growth throughout
the experiment and to achieve more than 90% virus-induced cell destruction in the
untreated controls after four days post-infection. After four days, plates are fixed
with 50% TCA and stained with sulforhodamine B. The optical density of the wells is
read in a microplate reader at 550 nm.
[0418] The 50% effective concentration (EC
50) values are defined as the compound concentration that achieved 50% reduction of
cytopathic effect of the virus.
Example 14: Plaque Reduction Assay
[0419] For a compound, the effective concentration is determined in duplicate 24-well plates
by plaque reduction assays. Cell monolayers are infected with 100 PFU/well of virus.
Then, serial dilutions of test compounds in MEM supplemented with 2% inactivated serum
and 0.75% of methyl cellulose are added to the monolayers. Cultures are further incubated
at 37°C for 3 days, then fixed with 50% ethanol and 0.8% Crystal Violet, washed and
air-dried. Then plaques are counted to determine the concentration to obtain 90% virus
suppression.
Example 15: Yield Reduction Assay
[0420] For a compound, the concentration to obtain a 6-log reduction in viral load is determined
in duplicate 24-well plates by yield reduction assays. The assay is performed as described
by
Baginski, S. G.; Pevear, D. C.; Seipel, M.; Sun, S. C. C.; Benetatos, C. A.; Chunduru,
S. K.; Rice, C. M. and M. S. Collett "Mechanism of action of a pestivirus antiviral
compound" PNAS USA 2000,97 (14), 7981-7986, with minor modifications.
[0421] Briefly, MDBK cells are seeded onto 24-well plates (2 x 10
5 cells per well) 24 hours before infection with BVDV (NADL strain) at a multiplicity
of infection (MOI) of 0.1 PFU per cell. Serial dilutions of test compounds are added
to cells in a final concentration of 0.5% DMSO in growth medium. Each dilution is
tested in triplicate. After three days, cell cultures (cell monolayers and supernatants)
are lysed by three freeze-thaw cycles, and virus yield is quantified by plaque assay.
Briefly, MDBK cells are seeded onto 6-well plates (5 x 10
5 cells per well) 24 h before use. Cells are inoculated with 0.2 mL of test lysates
for 1 hour, washed and overlaid with 0.5% agarose in growth medium. After 3 days,
cell monolayers are fixed with 3.5% formaldehyde and stained with 1% crystal violet
(w/v in 50% ethanol) to visualize plaques. The plaques are counted to determine the
concentration to obtain a 6-log reduction in viral load.
Example 16: Diagnosis of Norovirus Infection
[0422] One can diagnose a norovirus infection by detecting viral RNA in the stools of affected
persons, using reverse transcription-polymerase chain reaction (RT-PCR) assays. The
virus can be identified from stool specimens taken within 48 to 72 hours after onset
of symptoms, although one can obtain satisfactory results using RT-PCR on samples
taken as long as 7 days after the onset of symptoms. Other diagnostic methods include
electron microscopy and serologic assays for a rise in titer in paired sera collected
at least three weeks apart. There are also commercial enzyme-linked immunoassays available,
but these tend to have relatively low sensitivity, limiting their use to diagnosis
of the etiology of outbreaks. Clinical diagnosis of norovirus infection is often used,
particularly when other causative agents of gastroenteritis have been ruled out.
Example 17: In Vitro Antiviral Activity
[0423] In vitro anti-viral activity can be evaluated in the following cell lines:
The Norwalk G-I strain (
Chang, K. O., et al. (2006) Virology 353:463-473), the GII-4 strain replicon, as well other Norovirus replicons can be used in assays
to determine the
in vitro antiviral activity of the compounds described herein, or other compounds or compound
libraries.
[0424] In some embodiments, the replicon systems are subgenomic and therefore allow evaluation
of small molecule inhibitors of non-structural proteins. This can provide the same
benefits to Norovirus drug discovery that Hepatitis C replicons contributed to the
discovery of therapeutics useful for treatment of that virus (
Stuyver, L. J., et al. (2006) Antimicrob. Agents Chemother. 47:244-254). Both Norovirus replicons and Hepatitis C replicons require viral helicase, protease,
and polymerase to be functional in order for replication of the replicon to occur.
It is believed that the compounds described herein inhibit viral polymerase and/or
viral helicase.
[0425] The
in vitro cell culture infectivity assay reported using Norovirus genogroup I and II inoculums
(
Straub, T. M. et al. (2007) Emerg. Infect. Dis. 13(3):396-403) can also be used. This assay can be performed in a rotating-wall bioreactor utilizing
small intestinal epithelial cells on microcarrier beads. The infectivity assay can
be used for evaluating compounds for their ability to inhibit the desired virus.
Example 18: Antiviral Potency and Toxicity of Jakafi and tofacitinib in Primary Human
Lymphocytes and Macrophages
[0426] The antiviral potency and toxicity of jakafi and tofacitinib was evaluated in primary
human lymphocytes and macrophages, using the methodology outlined above.
[0427] The antiviral potency against HIV-1LAI in primary human lymphocytes was 0.1-0.8 µM
(EC
50) and 4.7-15.1 µM (EC
90). Antiviral potency against HIV-2 in primary human lymphocytes was 0.02-0.07 µM (EC
50) and 0.4-1.8 µM (EC
90). Antiviral potency against HIV-1BaL in primary human macrophages was approximately
0.3 µM (EC
50) and 3.0 µM (EC
90). AZT (control) demonstrated antiviral potency against HIV-1LAI, HIV-2, and HIV-1BaL
as expected. Toxicity (IC
50) measured with the MTT assay ranged from 1.3 to > 100 µM depending on the cell type
tested. Propidium Iodide (primary human lymphocytes) demonstrated IC
50> 50 µM. Data are mean and standard deviations from at least three independent experiments.
[0428] The data is shown below in Tables 1 and 2.
Table 1
Compound |
Anti-HIV-1 EC50 in acutely infected PBM cells (µM) |
Anti-HIV-1 EC90 in acutely infected PBM cells (µM) |
Anti-HIV-2 EC50 in acutely infected PBM cells (µM) |
Anti-HIV-2 EC90 in acutely infected PBM cells (µM) |
Anti-HIV-1 EC50 in acutely infected MΦ (µM) |
Anti-HIV-1 EC90 in acutely infected MΦ (µM) |
|
|
|
|
|
|
|
Jakafi |
0.1 ± 0.02 |
4.7 ± 0.07 |
0.02 ±0.01 |
0.4 ± 0.2 |
0.3 ± 0.1 |
3.1 ± 1.8 |
Tofacitinib |
0.8 ± 0.3 |
17.1 ± 15.1 |
0.07 ± 0.006 |
1.8 ± 1.1 |
0.2 ± 0.08 |
2.9 ± 1.4 |
AZT |
0.02 ± 0.008 |
0.13 ± 0.03 |
0.001 ± 0.0008 |
0.01 ± 0.01 |
0.01 ± 0.02 |
0.07 ± 0.12 |
Table 2
Compound |
IC50 in PHA+IL-2 PBM cells(µM) *MTT Assay |
IC50 in PHA stimulated PBM cells(µM) *MTT Assay |
IC50 in PBM cells(µM) *Propidium Iodide assay |
IC50 in Mφ(µM) *MTT Assay |
IC50 in CEM cells (µM) *MTT Assay |
IC50 in Vero cells(µM) *MTT Assay |
|
|
|
|
|
|
|
Jakafi |
3.1 ± 1.7 |
9.1 ± 1.3 |
> 50 |
> 100 |
11.8 ± |
29.3 ± 3.7 |
|
|
|
|
|
1.1 |
|
Tofacitinib |
1.3 ± 0.9 |
6.3 ± 1.8 |
> 50 |
49.2 |
>100 |
>100 |
AZT |
> 100 |
> 100 |
> 50 |
> 100 |
14.3 |
56.0 |
Example 19: Therapeutic Index for Jakafi and Tofacitinib in primary human lymphocytes
and macrophages.
[0429] The therapeutic index (ratio of toxicity:potency) for Jakafi and Tofacitinib was
evaluated in primary human lymphocytes and macrophages using the methodology described
above. The therapeutic index ranged from 1.0-31.0 for HIV-1 infection in primary human
lymphocytes when using MTT assay toxicity values, and were > 100 using propidium iodide
toxicity values. The therapeutic Index ranged from 18 to > 100 for HIV-2 infection
in primary human lymphocytes when using MTT assay toxicity values, and were > 100
using propidium iodide toxicity values. The therapeutic index for HIV-1 infection
in primary human macrophages was > 100 (MTT assay toxicity values).
[0430] The data are shown below in Tables 3 and 4.
Table 3
Compound |
TI forantiviral potency against acute HIV-1 infection in PBM cells versus toxicity * Calculated using MTT assay toxicity values for PHA+IL-2 stimulated PBM
cells |
TI forantiviral potency against acute HIV-1 infection in PBM cells versus toxicity * Calculated using MTT assay toxicity values for PHA stimulated PBM cells |
TI for antiviral potency against acute HIV-1 infection in PBM cells versus toxicity * Calculated using Propidium Iodide toxicity values |
|
|
|
|
Jakafi |
31.0 |
> 100 |
> 100 |
Tofacitinib |
1.0 |
8.0 |
> 100 |
AZT |
> 100 |
> 100 |
> 100 |
Table 4
Compound |
TI for antiviral potency against acute HIV-2 infection in PBM cells versus toxicity * Calculated using MTT assay toxicity values |
TI for antiviral potency against acute HIV-2 infection in PBM cells versus toxicity * Calculated using Propidium Iodide toxicity values |
TI for antiviral potency against acute HIV-1 infection versus toxicity in macrophages * Calculated using MTT assay toxicity values |
|
|
|
|
Jakafi |
> 100 |
> 100 |
> 100 |
Tofacitinib |
18.5 |
> 50 |
> 100 |
AZT |
> 100 |
> 50 |
> 100 |
Example 20: Viability of primary human lymphocytes exposed to various concentrations
of Jakafi or Tofacitinib.
[0431] The viability of primary human lymphocytes exposed to various concentrations of Jakafi
or Tofacitinib was determined using the techniques discussed above.
[0432] PHA and interleukin-2 (IL-2) stimulated primary human lymphocytes were exposed to
various concentrations of Jakafi or Tofacitinib for 5 days prior to assessment of
viability using propidium Iodide (flow cytometry).
[0433] Figures 4a-f show the results of flow cytometric analysis of PHA+IL-2 stimulated
primary human lymphocytes exposed to various concentrations of Jakafi or Tofacitinib
for 5 days prior to assessment of viability using propidium iodide (flow cytometry).
[0434] A gating strategy based on forward scatter (FSC) and side scatter (SSC) was established,
and used uniformly across all samples. Figure 4a is a scatter plot showing a Side
Scatter (SSC) gating strategy, where the X-axis in the first chart is Side Scatter
Pulse Height (SSC-h) and the Y-axis is Side Scatter Pulse Width (SSC-w), and in the
second chart, the forward-scattered light (FSC) is shown with the X axis being Forward
Scatter Pulse Height (FSC-H) and the Y axis being Forward Scatter Pulse Width (FSC-W).
The gating strategy based on forward scatter (FSC) and side scatter (SSC) was established
and used uniformly across all samples.
[0435] Cells incubated in the absence of drug were 92.8 % viable, and cells exposed to 95°C
heat for 1 minute (positive control for dead cells) were 2.8 % viable (Figure 4b).
[0436] Gating was established based on viable cells cultured in the absence of drug (Figure
4b). Histograms and scatter plots are representative data from at least 3 independent
experiments conducted with pooled cells from 8 donors. Graphs (E, F) are mean and
standard deviations compiled from each independent experiment.
[0437] Figure 4B is a histogram showing the results of flow cytometry studies using Propidium
Iodide stain quantified with the phycoerythrin (PE-A) channel. Only dead/dying cells
will stain positive for Propidium Iodide, therefore only dead/dying cells will be
detected by the PE channel using flow cytometry. Living, viable cells will not be
stained by Propidium Iodide, therefore they will not be detected in the PE channel.
Cells incubated in the absence of drug were 92.8 % viable (meaning that 92.8 % of
cells did not uptake Propidium Iodide stain), and the positive control of cells exposed
to 95°C heat for 1 minute were 2.8 % viable (meaning that 97.2 % of these cells stained
positive for Propidium Iodide and are therefore dead) (B). The data is shown in terms
of total percent of cells in each sample, where gating was established based on viable
cells cultured in the absence of drug.
[0438] Figure 4c shows histograms comparing the cell viability for cells exposed to Jakafi
and to no drug (i.e., controls) for concentrations of 0.1 µM Jakafi, 1.0 µM Jakafi,
10µM Jakafi, and 50 µM Jakafi.
[0439] Figure 4d shows histograms comparing the cell viability for cells exposed to Tofacitinib
and to no drug (i.e., controls) for concentrations of 0.1 µM Tofacitinib, 1.0 µM Tofacitinib,
10µM Tofacitinib, and 50 µM Tofacitinib.
[0440] Figures 4e and 4f are charts showing the mean and standard deviations from the experiments
shown in Figures 4c (Jakafi) and 4d (Tofacitinib), respectively.
[0441] The data showed that Jakafi did not significantly reduce viability
versus no drug controls for all concentrations tested with the exception of 50 µM (p < 0.05)(Figure
4c). The data also showed that Tofacitinib did not significantly reduce viability
versus no drug controls for all concentrations tested (Figure 4d).
Example 21: Viability of primary human lymphocytes exposed to various concentrations
of Jakafi or Tofacitinib.
[0442] The antiviral potency of Jakafi and Tofacitinib was evaluated in primary rhesus macaque
lymphocytes and macrophages using the techniques discussed above. The antiviral potency
was approximately 0.4 µM (EC
50) and 4.0 µM (EC
90) for both Jakafi and Tofacitinib in primary rhesus macaque macrophages. The antiviral
potency was 0.09 ± 0.1 (EC
50) and 1.3 ± 0.8 (EC
90) in primary rhesus macaque macrophages. An AZT control demonstrated antiviral potency
as expected. The data (Shown in Table 5 below) are mean and standard deviations from
at least three independent experiments.
Table 5
Drug |
Acute infection in rhesus macaque macrophages EC50(µM) |
Acute infection in rhesus macaque macrophages EC90 (µM) |
Acute infection in rhesus macaque lymphocytes EC50 (µM) |
Acute infection in rhesus macaque lymphocytes EC90 (µM) |
Jakafi |
0.4 ± 0.2 |
4.2 ± 1.3 |
0.09 ± 0.1 |
1.3 ± 0.8 |
Tofacitinib |
0.3 ± 0.2 |
3.1 ± 0.9 |
0.3 ± 0.1 |
2.9 ± 0.5 |
AZT |
0.08 ± 0.1 |
0.9 ± 0.7 |
0.002 ±0.001 |
0.03 0.02 |
Example 22: Synergistic antiviral potency for co-administration of Jakafi and Tofacitinib
in primary human lymphocytes and macrophages
[0443] The synergistic antiviral potentency for co-administration of Jakafi and Tofacitinib
was evaluated in primary human lymphocytes and macrophages, using the techniques described
above.
[0444] Co-administration of Jakafi and Tofacitinib at a ratio of 1:4 (lymphocytes) or 1:1
(macrophages) demonstrated synergistic antiviral potency, as calculated by CalcuSyn
(Biosoft, Inc., Cambridge, Great Britain). The results are shown in Figures 5a and
5b. EC
50 and EC
90 in lymphocytes were decreased by 5-fold and 117-fold, respectively (dotted lines,
Figure 5a). EC
50 and EC90 were markedly decreased in macrophages (Figure 5b).
Example 23: Antiviral potency and of Jakafi and Tofacitinib against various NRTI-resistant
HIV-1 in primary human lymphocytes.
[0445] The antiviral potency of Jakafi and Tofacitinib against various NRTI-resistant HIV-1
was evaluated in primary human lymphocytes using the techniques described above.
[0446] The antiviral potency of Jakafi and Tofacitinib was not significantly different for
wild-type HIV-1xxLAI versus that of HIV-1 containing mutations K65R, M184V, L74V,
A62V/V75I/F77L/F116Y/Q151M, or 4xAZT (D67N/K70R/T215Y/K219Q). Various controls for
each mutation demonstrated potency or resistance as expected. Efavirenz (EFV) was
similarly potent across all NRTI resistant strains as expected. Data are mean and
standard deviations calculated from at least 4 independent experiments, with pooled
cells from 8 donors and duplicates in each experiment.
[0447] The EC
50 data is shown in Table 6, and the EC
90 data is shown in Table 7.

Example 24: Fold increase 50 (FI50) and fold increase 90 (FI90) for Jakafi and Tofacitinib against various NRTI-resistant HIV-1 in primary human lymphocytes
[0448] The fold increase 50 (FI
50) and fold increase 90 (FI
90) for Jakafi and Tofacitinib against various NRTI-resistant HIV-1 was evaluated in
primary human lymphocytes, using the techniques described above. FI
50 is the ratio of EC
50 against mutant virus:EC
50 against wild-type xxLAI. FI
90 is the ratio of EC
90 against mutant virus:EC
90 against wild-type xxLAI. There was not significant increase in FI
50 or FI
90 for Jakafi or Tofacitinib treated cells. Controls of AZT, (-)-FTC, 3TC, d4T, ddI,
Efavirenz (EFV), TDF demonstrated sensitivity or resistance as expected.
[0449] The data is shown below in Table 8 (FI
50) and Table 9 (FI
90)

[0450] The data is also shown in Figures 6a and 6b. Jakafi and Tofacitinib did not display
a significant difference in FI
50 (Figure 6a) or FI
90 (Figure 6b) versus wild type HIV-1xxLAI for HIV-1 containing M184V, K65R, L74V, A62V/V75I/F77L/F116Y/Q151M,
or 4xAZT (D67N/K70R/T215Y/K219Q) containing mutations.
Example 25: Effect of various Jak inhibitors on proliferation and viability of PHA
or PHA+IL-2 stimulated primary human lymphocytes.
[0451] The effect of various Jak inhibitors on proliferation and viability of PHA or PHA+IL-2
stimulated primary human lymphocytes was evaluated using the techniques described
above. For PHA stimulated lymphocytes, viability and proliferation were not significantly
different than that of cell exposed to media alone for all concentrations of either
Jakafi or Tofacitinib (Figure 7a and Figure 7c). For PHA+IL-2 stimulated lymphocytes,
viability was not significantly different than that of cells exposed to media alone
for all concentrations of either Jakafi or Tofacitinib (Figure 7b), however proliferation
was significantly inhibited by 1.0 µM of Jakafi or Tofacitinib (Figure 7d).
[0452] For all experiments, cells were incubated with media alone or drug-containing medium
for 5 days prior to assessment of cell count and viability. Data are mean and standard
deviations for at least three independent experiments conducted with at least 4 pooled
donors, and duplicates within each experiment. The dotted bar represents mean cell
count or viability for cells maintained in drug-free medium.
Example 25: Tofacitinib and Jakafi inhibit reactivation of latent HIV-1.
[0454] The ability of Tofacitinib and Jakafi to inhibit reactivation of latent HIV-1 was
also evaluated in primary human macrophages. Primary human monocytes were obtained
by elutriation and differentiated to terminally differentiated macrophages in the
presence of m-CSF for 5 days. Cells were subsequently infected with VSV-pseudotyped
HIV-1 (envelope region), allowing for 100 % infection rate of cultures. Cells were
further cultured for 40 days until cultures were no longer producing HIV-1. At this
time, all macrophages are now resting, latently infected cells. 41 days post infection,
10 ng/ml phorbol myristate acetate (PMA) was applied to the latently infected macrophages
for 24 hr in either the absence of drug (positive control), or in the presence of
1.0 or 10.0 µM Jakafi or Tofacitinib. After 24 hr., both PMA and drug containing mediums
were removed, and cells were cultured in media alone. Samples were taken at various
days post reactivation and extracellular, reactivated virus production was quantified
using p24 ELISA. Results are reported as percent inhibition of reactivation of latent
HIV-1 versus no drug control. The results are shown in Figures 9a (Tofacitinib) and
9b (Jakafi). Both Tofacitinib and Jakafi inhibit reactivation of latent HIV-1 in primary
human macrophages when drug is applied to cells during reactivation, but removed thereafter.
Tofacitinib inhibits ∼ 40 % of reactivation while Jakafi inhibits ∼ 35 % of reactivation
within 72 hr post reactivation.
Example 26: Tofacitinib and Jakafi inhibit a pro-HIV cytokine (IFN-a) induced activation
of the Jak-STAT pathway.
[0455] Tofacitinib and Jakafi inhibit a pro-HIV cytokine (IFN-a) induced activation of the
Jak-STAT pathway. Jakafi and Tofacitinib inhibit IFN-α induced phosphorylation of
STAT1, 3, and 5 in primary CD4+ T lymphocytes at sub-micromolar concentrations (A,
B, C).
Example 27: Tofacitinib and Jakafi inhibit a pro-HIV cytokine (IFN-a) induced activation
of the Jak-STAT pathway.
[0456] The ability of Tofacitinib and Jakafi to inhibit a pro-HIV cytokine (IFN-α) induced
activation of the Jak-STAT pathway was evaluated using techniques described above.
Jakafi and Tofacitinib inhibit IFN-α induced phosphorylation of STAT1, 3, and 5 in
primary CD4+ T lymphocytes at sub-micromolar concentrations, as shown below in Table
10. Both drugs also inhibit pSTAT1, 3, and 5 with similar EC
50/
90 in CD8 T cells and CD14 monocytes (data not shown).
Table 10
Drug |
EC50/90 pSTAT1 (µM) |
EC50/90 pSTAT3 (µM) |
EC50/90 pSTAT5 (µM) |
(Tofacitinib/Xalij enz) |
< 0.01/0.01 |
0.02/0.9 |
< 0.01/0.01 |
(Jakafi) |
<0.01/< 0.01 |
< 0.01/0.01 |
< 0.01/< 0.01 |
[0457] The present invention also relates to the following numbered clauses.
Clause 1. The use of a compound of Formula A:

wherein:
or the pharmaceutically acceptable salt thereof; wherein
R1 is a group of the formula

wherein y is 0, 1 or 2;
R4 is selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C2-C6)alkenyl, (C2-C6)alkynyl wherein the alkyl, alkenyl and alkynyl groups are optionally substituted
by deuterium, hydroxy, amino, trifluoromethyl, (C1-C4)alkoxy, (C1-C6)acyloxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, nitro, (C2-C6)alkenyl, (C2-C6)alkynyl or (C1-C6)acylamino; or
R4 is (C3-C10)cycloalkyl wherein the cycloalkyl group is optionally substituted by deuterium, hydroxy,
amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R5 is (C2-C9)heterocycloalkyl wherein the heterocycloalkyl groups must be substituted by one to
five carboxy, cyano, amino, deuterium, hydroxy, (C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(Ci-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO-( C1-C6)alkyl, (C1-C6)alkyl-S(O)m, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl; or a group of the formula
wherein a is 0, 1, 2, 3 or 4;
b, c, e, f and g are each independently 0 or 1;
d is 0, 1, 2, or 3;
X is S(O)n wherein n is 0, 1 or 2; oxygen, carbonyl or --C(=N-cyano)-;
Y is S(O)n wherein n is 0, 1 or 2; or carbonyl; and
Z is carbonyl, C(O)O--, C(O)NR-- or S(O)n wherein n is 0, 1 or 2;
R6, R7, R8, R9, R10 and R11 are each independently selected from the group consisting of hydrogen or (C1-C6)alkyl optionally substituted by deuterium, hydroxy, amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R12 is carboxy, cyano, amino, oxo, deuterium, hydroxy, trifluoromethyl, (C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO--( C1-C6)alkyl, R15C(O)NH, R15OC(O)NH, R15NHC(O)NH, (C1-C6)alkyl-S(O)m, (C1-C6)alkyl-S(O)m--(C1-C6)alkyl, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16N(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl;
R2 and R3 are each independently selected from the group consisting of hydrogen, deuterium,
amino, halo, hydroxy, nitro, carboxy, (C2-C6)alkenyl, (C2-C6)alkynyl, trifluoromethyl, trifluoromethoxy, (C1-C6)alkyl, (C1-C6)alkoxy, (C3-C10)cycloalkyl wherein the alkyl, alkoxy or cycloalkyl groups are optionally substituted
by one to three groups selected from halo, hydroxy, carboxy, amino (C1-C6)alkylthio, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl, (C3-C9)cycloalkyl or (C6-C10)aryl; or R2 and R3 are each independently (C3-C10)cycloalkyl, (C3-C10)cycloalkoxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C6-C10)arylamino, (C1-C6)alkylthio, (C6-C10)arylthio, (C1-C6)alkylsulfinyl, (C6-C10)arylsulfinyl, (C1-C6)alkylsulfonyl, (C6-C10)arylsulfonyl, (C1-C6)acyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkylamino-CO--, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl or (C6-C10)aryl wherein the heteroaryl, heterocycloalkyl and aryl groups are optionally substituted
by one to three halo, (C1-C6)alkyl, (C1-C6)alkyl-CO--NH--, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, carboxy(C1-C6)alkoxy, benzyloxycarbonyl(C1-C6)alkoxy, (C1-C6)alkoxycarbonyl(C1-C6)alkoxy, (C6-C10)aryl, amino, amino(C1-C6)alkyl, (C1-C6)alkoxycarbonylamino, (C6-C10)aryl(C1-C6)alkoxycarbonylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C1-C6)alkylamino(C1-C6)alkyl, ((C1-C6)alkyl)2amino(C1-C6)alkyl, hydroxy, (C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, (C1-C6)alkoxycarbonyl, (C1-C6)alkoxycarbonyl(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--, cyano, (C5-C9)heterocycloalkyl, amino-CO--NH--, (C1-C6)alkylamino-CO--NH--, ((C1-C6)alkyl)2amino-CO--NH--, (C6-C10)arylamino-CO-NH--, (C5-C9)heteroarylamino-CO--NH--, (C1-C6)alkylamino-CO--NH--( C1-C6)alkyl, ((C1-C6)alkyl)zamino-CO--NH--(C1-C6)alkyl, (C6-C10)arylamino-CO--NH-(C1-C6)alkyl, (C5-C9)heteroarylamino-CO--NH--(C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C6-Cio)arylsulfonyl, (C6-C10)arylsulfonylamino, (C6-C10)arylsulfonylamino(C1-C6)alkyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C5-C9)heteroaryl or (C2-C9)heterocycloalkyl.
or of Formula B:

including pharmaceutically acceptable salt forms or prodrugs thereof, wherein:
A1 and A2 are independently selected from C and N;
T, U, and V are independently selected from O, S, N, CR5, and NR6;
wherein the 5-membered ring formed by A1, A2, U, T, and V is aromatic;
X is N or CR4;
Y is C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, (CR11R12)p--(C3-10 cycloalkylene)-(CR11R12)q, (CR11R12)p-(arylene)-(CR11R12)q, (CR11R12)\p--(C1-10 heterocycloalkylene)-(CR11R12)q, (CR11R12)p-(heteroarylene)-(CR11R12)q, (CR11R12)pO(CR11R12 )q, (CR11R12)pS(CR11R12)q, (CR11R12)pC(O)(CR11R12 )q, (CR11R12)pC(O)NRc(CR11R12)q, (CR11R12)pC(O)O(CR11R12)q, (CR11R12)pOC(O)( CR11R12)q, (CR11R12)pOC(O)NRc(CR11R12)q, (CR11R12)pNRc(CR11R12)q, (CR11R12)pNRcC(O)NRd(CR11R12)q, (CR11R12)pS(O)(CR11R12)q, (CR11R12)pS(O)NRc(CR11R12)q, (CR11R12)pS(O)2(CR11R12)q, or (CR11R12)pS(O)2NRc(CR11R12)q, wherein said C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, cycloalkylene, arylene, heterocycloalkylene, or heteroarylene, is optionally
substituted with 1, 2, or 3 substituents independently selected from -D1-D2-D3-D4;
Z is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, =C--Ri, =N--Ri, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, N2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
wherein when Z is H, n is 1;
or the --(Y)n-Z moiety is taken together with i) A2 to which the moiety is attached, ii) R5 or R6 of either T or V, and iii) the C or N atom to which the R5 or R6 of either T or V is attached to form a 4- to 20-membered aryl, cycloalkyl, heteroaryl,
or heterocycloalkyl ring fused to the 5-membered ring formed by A1 A2, U, T, and V, wherein said 4- to 20-membered aryl, cycloalkyl, heteroaryl, or heterocycloalkyl
ring is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected
from-(W)m-Q;
W is C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, O, S, C(O), C(O)NRc', C(O)O, OC(O), OC(O)NRc', NRc', NRc'C(O)NRd', S(O), S(O)NRc', S(O)2, or S(O)2NRc';
Q is H, halo, CN, NO2, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl, wherein
said C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl is optionally substituted
with 1, 2, 3 or 4 substituents independently selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy2, CN, NO2, ORa', SRa', C(O)Rb', C(O)NRc'Rd', C(O)ORa', OC(O)Rb', OC(O)NRc'Rd', NRc'Rd', NRc'C(O)Rb', NRc'C(O)N Rc'Rd', N Rc'C(O)ORa', S(O)Rb', S(O)N Rc'Rd', S(O)2Rb', NRc'S(O)2Rb', and S(O)2N Rc'Rd';
Cy1 and Cy2 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl,
each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected
from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, CN, NO2, ORa", SRa", C(O)Rb", C(O)NRc''Rd", C(O)ORa", OC(O)Rb", OC(O)N Rc''Rd", NRc''Rd", NRc''C(O)Rb", NRc"C(O)ORa", NRc"S(O)Rb", NRc"S(O)2Rb", S(O)Rb", S(O)NRc"Rd", S(O)2Rb", and S(O)2NRc"Rd";
R1, R2, R3, and R4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NRcC(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, and S(O)2NR9R10;
R5 is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7, OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NR9C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, or S(O)2NR9R10;
R6 is H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, OR7, C(O)R8, C(O)NR9R10, C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, or S(O)2NR9R10;
R7 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R8 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R9 and R10 are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, C1-6 alkylcarbonyl, arylcarbonyl, C1-6 alkylsulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl,
heteroarylalkyl, cycloalkylalkyl and heterocycloalkylalkyl;
or R9 and R10 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group;
R11 and R12 are independently selected from H and -E1-E2-E3-E4;
D1 and E1 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D2 and E2 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, (C1-6 alkylene)r--O--(C1-6 alkylene)s, (C1-6 alkylene)r--S--(C1-6 alkylene)s, (C1-6 alkylene)r--NRc--(C1-6 alkylene)s, (C1-6 alkylene)r--CO--(C1-6 alkylene)s, (C1-6 alkylene)r--COO--(C1-6 alkylene)s, (C1-6 alkylene)r-CONRc-(C1-6 alkylene)s, (C1-6 alkylene)r--SO--(C1-6 alkylene)s, (C1-6 alkylene)r--SO2--(C1-6 alkylene)s, (C1-6 alkylene)r--SONRc--(C1-6 alkylene)s, and (C1-6 alkylene)r-NRcCONRf--(C1-6 alkylene)s, wherein each of the C1-6 alkylene, C2-6 alkenylene, and C2-6 alkynylene is optionally substituted by 1, 2 or 3 substituents independently selected
from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D3 and E3 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
E4 and E4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRa, C(O)ORa, OC(O)RbOC(O)NRcRd NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
Ra is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb is H, Cy1, -(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-61-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ra' and Ra" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb' and Rb" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc and Rd are independently selected from H, Cy1, --(C1-6 alkyl)-Cy1, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl, is optionally substituted with 1, 2, or 3 substituents independently selected
from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
Rc' and Rd' are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
or Rc' and Rd' together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc" and Rd" are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, C1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;
or Rc" and Rd" together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ri is H, CN, NO2, or C1-6 alkyl;
Re and Rf are independently selected from H and C1-6 alkyl;
Ri is H, CN, or NO2;
m is 0 or 1;
n is 0 or 1;
p is 0, 1, 2, 3, 4, 5, or 6;
q is 0, 1, 2, 3, 4, 5 or 6;
r is 0 or 1; and
s is 0 or 1,
in the preparation of a medicament for use in treating or preventing an HIV infection.
Clause 2. The use of an effective antiviral amount of a JAK inhibitor selected from
the group consisting of CEP-701 (Lestaurtinib), AZD1480, LY3009104/INCB28050 Pacritinib/SB1518,
VX-509, GLPG0634, INC424, R-348, CYT387, TG 10138, AEG 3482, 7-iodo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acryl
amide, 7-(3-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2amine, N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phen-
yl)acrylamide, N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, methyl 2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxylate,
N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(4-amino-3-methoxyphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide, N,N-dimethyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
1-ethyl-3-(2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)urea,
N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide,
2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)pheno- 1, 2-cyano-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)phenyl)acetamide,
N-(cyanomethyl)-2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxamide,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
1-ethyl-3-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)-2-(-trifluoromethoxy)phenyl)urea
20. N-(3-nitrophenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-iodo-N-(3-nitrophenyl)thieno[3,2-d]pyrimidin-2-amine,
N1-(7-(2-ethylphenyl)thieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be-
nzenesulfonamide, N1-(7-iodothieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, 7-(4-amino-3-(tri
fluoromethoxy)phenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, 7-(2-ethylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl-)acetamide, N-(cyanomethyl)-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(cyanomethyl)-N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(3-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-l)phenyl)methanesulfonamide,
4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide,
N-(4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-iodo-N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(2-isopropylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-bromo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 40. N7-(2-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
N7-(4-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
7-(5-amino-2-methylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(cyanomethyl)-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
7-iodo-N-(3-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,. 7-(4-amino-3-nitrophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(2-methoxypyridin-3-yl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(7-iodothieno[3,2-d]pyrimidin-2-ylamino)phenyl)methanol,
N-tert-butyl-3-(2-(3-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be- nzenesulfonamide,
N-tert-butyl-3-(2-(3-(hydroxymethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-morpholinophenyl)-7-(4-nitrophenylthio)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(4-amino-3-nitrophenyl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine 53.
N-(3,4-dimethoxyphenyl)-7-(2-methoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4-dimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(2-aminopyrimidin-5-yl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, N-(3,4-dimethoxyphenyl)-7-(2,6-dimethoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-(2,4-dimethoxypyrimidin-5-yl)thieno[3,2-d]pyrimidin-2-amine,
7-iodo-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,.
2-cyano-N-(4-methyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,.
ethyl 3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzoate, 7-bromo-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,.
N-(3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(cyanomethyl)-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)benzamide,.
N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
tert-butyl-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-pyrazole-1-carboxylate,
7-bromo-N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-tert-butyl-3 -(2-(4-((4-ethylpiperazin-1-yl)methyl)phenylamino)thieno[3,- 2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(cyanomethyl)-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]-pyrimidin-7-yl)benzenesulfonamide,
tert-butyl pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(3-chloro-4-fluorophenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl-)-1H-pyrazole-1-carboxylate,
7-(benzo[d][1,3]dioxol-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 5-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-ind-
ole-1-carboxylate, 7-(2-aminopyrimidin-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-5,6-di-hydropyridine-1(2H)-carboxylate,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-phenyl)acetamide,
N-(4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-(4-(4-methylpiperazin-1-yl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
N-(2-methoxy-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
7-bromo-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, (3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, N-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzyl)methanesulfonamide,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(4-(morpholinomethyl)phenyl)-7-(3-(piperazin-1-yl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(6-(2-morpholinoethylamino)pyridin-3-yl)-N-(3,4,5-trimethoxyphenyl)thie-no[3,2-d]pyrimidin-2-amine,
7-(2-ethylphenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-(aminomethyl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(4-(1-ethylpiperidin-4-yloxy)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,.
N-(2,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-bromo-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine,
and pharmaceutically acceptable salts and prodrugs thereof,
in the preparation of a medicament for use in treating or preventing an HIV infection.
Clause 3. The use of Clause 1 or Clause 2, wherein the medicament further comprises:
- a) at least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or
- b) at least one additional antiviral agent selected from the group consisting of non-nucleoside
reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion inhibitors,
entry inhibitors, attachment inhibitors, and integrase inhibitors.
Clause 4. The use of Clause 3, wherein the thymidine nucleoside antiretroviral agent
is zidovudine (AZT).
Clause 5. The use of Clause 3, wherein the thymidine nucleoside antiretroviral agent
is DAPD or APD.
Clause 6. The use of Clause 3, wherein the nucleoside antiretroviral agents comprise:
- a) (-)-FTC or 3TC,
- b) TDF,
- c) DAPD or APD,
- d) AZT, and
- e) a NNRTI, a protease inhibitor, or an integrase inhibitor.
Clause 7. The use of Clause 6, wherein the NNRTI is Sustiva, the protease inhibitor
is Kaletra, or the integrase inhibitor is Raltegravir or Elvitegravir.
Clause 8. The use of Clause 3, wherein the compound of Formula A or B, and the at
least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or at least one additional antiviral agent selected from the group consisting
of non-nucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion
inhibitors, entry inhibitors, attachment inhibitors, and integrase inhibitors, are
administered in combination.
Clause 9. The use of Clause 3, wherein the compound of Formula A or B, and the at
least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or at least one additional antiviral agent selected from the group consisting
of non-nucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion
inhibitors, entry inhibitors, attachment inhibitors, and integrase inhibitors, are
administered in alternation.
Clause 10. The use of Clause 1, wherein the compound of Formula A is

or a pharmaceutically acceptable salt or prodrug thereof.
Clause 11. The use of Clause 1, wherein the compound of Formula B is

or a pharmaceutically acceptable salt or prodrug thereof..
Clause 12. The use of any of Clauses 1-11, wherein the medicament further comprises
a macrophage depleting agent.
Clause 13. The use of a combination of HAART, a JAK inhibitor of any of Clauses 1-11A,
and a macrophage depleting agent in the preparation of a medicament for treating or
eradicating an HIV infection.
Clause 14. The use of Clause 13, wherein the macrophage depleting agent is Boniva
or Fosamax.
Clause 15. The use of Clause 13, wherein the JAK inhibitor is

or

or a pharmaceutically acceptable salt or prodrug thereof.
Clause 16. The use of a combination of HAART, a JAK inhibitor of any of Clauses 1-11A,
and a reactivation agent in the preparation of a medicament for treating or eradicating
an HIV infection.
Clause 17. The use of Clause 16, wherein the reactivation agent is panobinostat.
Clause 18. The use of Clause 16, wherein the JAK inhibitor is

or

or a pharmaceutically acceptable salt or prodrug thereof.
Clause 19. The use of an effective, antiviral amount of a JAK inhibitor compound of
Clause 1 or Clause 2 in the preparation of a medicament for use in treating a viral
disease.
Clause 20. The use of Clause 19, wherein the medicament further comprises a second
anti-viral agent selected from the group consisting of an interferon, a ribavirin,
an interleukin, a NS3 protease inhibitor, a NS5A inhibitor, a cysteine protease inhibitor,
a phenanthrenequinone, a thiazolidine derivative, a thiazolidine, a benzanilide, a
helicase inhibitor, a polymerase inhibitor, a nucleotide analogue, a gliotoxin, a
cerulenin, an antisense phosphorothioate oligodeoxynucleotide, an inhibitor of IRES-dependent
translation, and a ribozyme.
Clause 21. The use of Clause 20, wherein the second agent is selected from the group
consisting of pegylated interferon alpha 2a, interferon alphacon-1, natural interferon,
albuferon, interferon beta- la, omega interferon, interferon alpha, interferon gamma,
interferon tau, interferon delta and interferon γ-lb.
Clause 22. The use of Clause 19, wherein the viral disease is caused by a virus selected
from the group consisting of an adenovirus, an Alphaviridae, an Arbovirus, an Astro
virus, a Bunyaviridae, a Coronaviridae, a Filoviridae, a Flaviviridae, a Hepadnaviridae,
a Herpesviridae (such as HSV-1, HSV-2, EBV, CMV), an Alphaherpesvirinae, a Betaherpesvirinae,
a Gammaherpesvirinae, a Norwalk Virus, an Astroviridae, a Caliciviridae, an Orthomyxoviridae,
a Paramyxoviridae, a Paramyxoviruses, a Rubulavirus, a Morbillivirus, a Papovaviridae,
a Parvoviridae, a Picornaviridae, an Aphthoviridae, a Cardioviridae, an Enteroviridae,
a Coxsackie virus, a Polio Virus, a Rhinoviridae, a Phycodnaviridae, a Poxviridae,
a Reoviridae, a Rotavirus, a Retroviridae, an A-Type Retrovirus, an Immunodeficiency
Virus, a Leukemia Viruses, an Avian Sarcoma Viruses, a Rhabdoviruses, a Rubiviridae
and a Togaviridae.
Clause 23. The use of Clause 19, wherein the viral disease is caused by a Flaviviridae
virus.
Clause 24. The use of Clause 19, wherein the viral disease is caused by a Dengue virus
or a Chikungunya virus.
Clause 25. The use of Clause 19, wherein the viral disease is caused by a BVDV virus.
Clause 26. The use of Clause 19, wherein the viral disease is caused by a West Nile
virus.
Clause 27. The use of Clause 19, wherein the viral disease is caused by a hepatitis
B virus.
Clause 28. The use of Clause 19, wherein the viral disease is caused by a hepatitis
C virus.
Clause 29. The use of Clause 19, wherein the viral disease is the result of a co-infection
of a hepatitis C virus with HIV and/or HBV.
Clause 30. The use of a combination of HAART, a JAK inhibitor of any of Clauses 1-11A,
and an anti-HIV vaccine and/or an immunostimulatory agent in the preparation of a
medicament for treating or eradicating an HIV infection.
Clause 31. The use of Clause 30, wherein the HAART comprises:
- a) at least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or
- b) at least one additional antiviral agent selected from the group consisting of non-nucleoside
reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion inhibitors,
entry inhibitors, attachment inhibitors, and integrase inhibitors.
Clause 32. The use of Clause 31, wherein the thymidine nucleoside antiretroviral agent
is zidovudine (AZT).
Clause 33. The use of Clause 31, wherein the thymidine nucleoside antiretroviral agent
is DAPD or APD.
Clause 34. The use of Clause 31, wherein the nucleoside antiretroviral agents comprise:
- a) (-)-FTC or 3TC,
- b) TDF,
- c) DAPD or APD,
- d) AZT, and
- e) a NNRTI, a protease inhibitor, or an integrase inhibitor.
Clause 35. The method of Clause 34, wherein the NNRTI is Sustiva, the protease inhibitor
is Kaletra, or the integrase inhibitor is Raltegravir or Elvitegravir.
Clause 36. The method of Clause 31, wherein the JAK inhibitor, HAART, and vaccine
or immunostimulatory compound are administered in combination.
Clause 37. The method of Clause 31, wherein the JAK inhibitor, HAART, and vaccine
or immunostimulatory compound are administered in alternation.
Clause 38. A method for treating or preventing an HIV infection, comprising administering
to a patient in need thereof an effective antiviral amount of a compound of Formula
A:

wherein:
or the pharmaceutically acceptable salt thereof; wherein
R1 is a group of the formula

wherein y is 0, 1 or 2;
R4 is selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C2-C6)alkenyl, (C2-C6)alkynyl wherein the alkyl, alkenyl and alkynyl groups are optionally substituted
by deuterium, hydroxy, amino, trifluoromethyl, (C1-C4)alkoxy, (C1-C6)acyloxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, nitro, (C2-C6)alkenyl, (C2-C6)alkynyl or (C1-C6)acylamino; or
R4 is (C3-C10)cycloalkyl wherein the cycloalkyl group is optionally substituted by deuterium, hydroxy,
amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R5 is (C2-C9)heterocycloalkyl wherein the heterocycloalkyl groups must be substituted by one to
five carboxy, cyano, amino, deuterium, hydroxy, (C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)zamino(C1-C6)acyl, R15R16N--CO-O--, R15R16N-CO-(C1-C6)alkyl, (C1-C6)alkyl-S(O)m, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl; or a group of the formula
wherein a is 0, 1, 2, 3 or 4;
b, c, e, f and g are each independently 0 or 1;
d is 0, 1, 2, or 3;
X is S(O)n wherein n is 0, 1 or 2; oxygen, carbonyl or --C(=N-cyano)-;
Y is S(O)n wherein n is 0, 1 or 2; or carbonyl; and
Z is carbonyl, C(O)O--, C(O)NR-- or S(O)n wherein n is 0, 1 or 2;
R6, R7, R8, R9, R10 and R11 are each independently selected from the group consisting of hydrogen or (C1-C6)alkyl optionally substituted by deuterium, hydroxy, amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R12 is carboxy, cyano, amino, oxo, deuterium, hydroxy, trifluoromethyl, (C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N-CO-(C1-C6)alkyl, R15C(O)NH, R15OC(O)NH, R15NHC(O)NH, (C1-C6)alkyl-S(O)m, (C1-C6)alkyl-S(O)m--(C1-C6)alkyl, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16N(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl;
R2 and R3 are each independently selected from the group consisting of hydrogen, deuterium,
amino, halo, hydroxy, nitro, carboxy, (C2-C6)alkenyl, (C2-C6)alkynyl, trifluoromethyl, trifluoromethoxy, (C1-C6)alkyl, (C1-C6)alkoxy, (C3-C10)cycloalkyl wherein the alkyl, alkoxy or cycloalkyl groups are optionally substituted
by one to three groups selected from halo, hydroxy, carboxy, amino (C1-C6)alkylthio, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl, (C3-C9)cycloalkyl or (C6-C10)aryl; or R2 and R3 are each independently (C3-C10)cycloalkyl, (C3-C10)cycloalkoxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C6-C10)arylamino, (C1-C6)alkylthio, (C6-C10)arylthio, (C1-C6)alkylsulfinyl, (C6-C10)arylsulfinyl, (C1-C6)alkylsulfonyl, (C6-C10)arylsulfonyl, (C1-C6)acyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkylamino-CO--, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl or (C6-C10)aryl wherein the heteroaryl, heterocycloalkyl and aryl groups are optionally substituted
by one to three halo, (C1-C6)alkyl, (C1-C6)alkyl-CO--NH-, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, carboxy(C1-C6)alkoxy, benzyloxycarbonyl(C1-C6)alkoxy, (C1-C6)alkoxycarbonyl(C1-C6)alkoxy, (C6-C10)aryl, amino, amino(C1-C6)alkyl, (C1-C6)alkoxycarbonylamino, (C6-C10)aryl(C1-C6)alkoxycarbonylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C1-C6)alkylamino(C1-C6)alkyl, ((C1-C6)alkyl)2amino(C1-C6)alkyl, hydroxy, (C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, (C1-C6)alkoxycarbonyl, (C1-C6)alkoxycarbonyl(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--, cyano, (C5-C9)heterocycloalkyl, amino-CO--NH--, (C1-C6)alkylamino-CO--NH--, ((C1-C6)alkyl)2amino-CO-NH-, (C6-C10)arylamino-CO-NH--, (C5-C9)heteroarylamino-CO--NH--, (C1-C6)alkylamino-CO--NH--(C1-C6)alkyl, ((C1-C6)alkyl)2amino-CO--NH--( C1-C6)alkyl, (C6-C10)arylamino-CO--NH-( C1-C6)alkyl, (C5-C9)heteroarylamino-CO--NH--(C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C6-Cio)arylsulfonyl, (C6-C10)arylsulfonylamino, (C6-C10)arylsulfonylamino(C1-C6)alkyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C5-C9)heteroaryl or (C2-C9)heterocycloalkyl.
or of Formula B:

including pharmaceutically acceptable salt forms or prodrugs thereof, wherein:
A1 and A2 are independently selected from C and N;
T, U, and V are independently selected from O, S, N, CR5, and NR6;
wherein the 5-membered ring formed by A1, A2, U, T, and V is aromatic;
X is N or CR4;
Y is C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, (CR11R12)p--(C3-10 cycloalkylene)-(CR11R12)q, (CR11R12)p-(arylene)-(CR11R12)q, (CR11R12)\p--(C1-10 heterocycloalkylene)-(CR11R12)q, (CR11R12)p-(heteroarylene)-(CR11R12)q, (CR11R12)pO(CR11R12)q, (CR11R12)pS(CR11R12)q, (CR11R12)pC(O)(CR11R12)q, (CR11R12)pC(O)NRc(CR11R12)q, (CR11R12)pC(O)O(CR11R12)q, (CR11R12)pOC(O)( CR11R12)q, (CR11R12)pOC(O)NRc(CR11R12)q, (CR11R12)pNRc(CR11R12)q, (CR11R12)pNRcC(O)NRd(CR11R12)q, (CR11R12)pS(O)(CR11R12)q, (CR11R12)pS(O)NRc(CR11R12)q, (CR11R12)pS(O)2(CR11R12)q, or (CR11R12)pS(O)2NRc(CR11R12)q, wherein said C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, cycloalkylene, arylene, heterocycloalkylene, or heteroarylene, is optionally
substituted with 1, 2, or 3 substituents independently selected from -D1-D2-D3-D4;
Z is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, =C--Ri, =N--Ri, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, N2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
wherein when Z is H, n is 1;
or the --(Y)n-Z moiety is taken together with i) A2 to which the moiety is attached, ii) R5 or R6 of either T or V, and iii) the C or N atom to which the R5 or R6 of either T or V is attached to form a 4- to 20-membered aryl, cycloalkyl, heteroaryl,
or heterocycloalkyl ring fused to the 5-membered ring formed by A1 A2, U, T, and V, wherein said 4- to 20-membered aryl, cycloalkyl, heteroaryl, or heterocycloalkyl
ring is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected
from-(W)m-Q;
W is C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, O, S, C(O), C(O)NRc', C(O)O, OC(O), OC(O)NRc', NRc', NRc'C(O)NRd', S(O), S(O)NRc', S(O)2, or S(O)2NRc';
Q is H, halo, CN, NO2, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl, wherein
said C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl is optionally substituted
with 1, 2, 3 or 4 substituents independently selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy2, CN, NO2, ORa', SRa', C(O)Rb', C(O)NRc'Rd', C(O)ORa', OC(O)Rb', OC(O)NRc'Rd', NRc'Rd', NRc'C(O)Rb', NRc'C(O)N Rc'Rd', N Rc'C(O)ORa', S(O)Rb', S(O)N Rc'Rd', S(O)2Rb', NRc'S(O)2Rb', and S(O)2N Rc'Rd';
Cy1 and Cy2 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl,
each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected
from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, CN, NO2, ORa", SRa", C(O)Rb", C(O)NRc''Rd", C(O)ORa", OC(O)Rb", OC(O)N Rc''Rd", NRc''Rd", NRc''C(O)Rb", NRc"C(O)ORa", NRc"S(O)Rb", NRc"S(O)2Rb", S(O)Rb", S(O)NRc"Rd", S(O)2Rb", and S(O)2NRc"Rd";
R1, R2, R3, and R4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NRcC(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, and S(O)2NR9R10;
R5 is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7, OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NR9C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, or S(O)2NR9R10;
R6 is H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, OR7, C(O)R8, C(O)NR9R10, C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, or S(O)2NR9R10;
R7 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R8 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R9 and R10 are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, C1-6 alkylcarbonyl, arylcarbonyl, C1-6 alkylsulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl,
heteroarylalkyl, cycloalkylalkyl and heterocycloalkylalkyl;
or R9 and R10 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group;
R11 and R12 are independently selected from H and -E1-E2-E3-E4;
D1 and E1 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D2 and E2 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, (C1-6 alkylene)r--O--(C1-6 alkylene)s, (C1-6 alkylene)r--S--(C1-6 alkylene)s, (C1-6 alkylene)r--NRc--(C1-6 alkylene)s, (C1-6 alkylene)r--CO--(C1-6 alkylene)s, (C1-6 alkylene)r--COO--(C1-6 alkylene)s, (C1-6 alkylene)r-CONRc-(C1-6 alkylene)s, (C1-6 alkylene)r--SO--(C1-6 alkylene)s, (C1-6 alkylene)r--SO2--(C1-6 alkylene)s, (C1-6 alkylene)r--SONR--(C1-6 alkylene)s, and (C1-6 alkylene)r-NRcCONRf--(C1-6 alkylene)s, wherein each of the C1-6 alkylene, C2-6 alkenylene, and C2-6 alkynylene is optionally substituted by 1, 2 or 3 substituents independently selected
from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D3and E3 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
E4 and E4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRa, C(O)ORa, OC(O)RbOC(O)NRcRd NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
Ra is H, Cy1, -(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-61-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ra' and Ra" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb' and Rb" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc and Rd are independently selected from H, Cy1, --(C1-6 alkyl)-Cy1, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl, is optionally substituted with 1, 2, or 3 substituents independently selected
from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
Rc' and Rd' are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
or Rc' and Rd' together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc" and Rd" are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, C1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;
or Rc" and Rd" together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ri is H, CN, NO2, or C1-6 alkyl;
Re and Rf are independently selected from H and C1-6 alkyl;
Ri is H, CN, or NO2;
m is 0 or 1;
n is 0 or 1;
p is 0, 1, 2, 3, 4, 5, or 6;
q is 0, 1, 2, 3, 4, 5 or 6;
r is 0 or 1; and
s is 0 or 1.
Clause 39. A method for treating or preventing an HIV infection, comprising administering
to a patient in need thereof an effective antiviral amount of a JAK inhibitors selected
from the group consisting of CEP-701 (Lestaurtinib), AZD1480, LY3009104/INCB28050
Pacritinib/SB1518, VX-509, GLPG0634, INC424, R-348, CYT387, TG 10138, AEG 3482, 7-iodo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acryl
amide, 7-(3-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2amine, N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phen-
yl)acrylamide, N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, methyl 2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxylate,
N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(4-amino-3-methoxyphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide, N,N-dimethyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
1-ethyl-3-(2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)urea,
N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide,
2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)pheno- 1, 2-cyano-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)phenyl)acetamide,
N-(cyanomethyl)-2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxamide,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
1-ethyl-3-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)-2-(-trifluoromethoxy)phenyl)urea
20. N-(3-nitrophenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-iodo-N-(3-nitrophenyl)thieno[3,2-d]pyrimidin-2-amine,
N1-(7-(2-ethylphenyl)thieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be-
nzenesulfonamide, N1-(7-iodothieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, 7-(4-amino-3-(tri
fluoromethoxy)phenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, 7-(2-ethylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl- )acetamide, N-(cyanomethyl)-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(cyanomethyl)-N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(3-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-l)phenyl)methanesulfonamide,
4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide,
N-(4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-iodo-N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(2-isopropylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-bromo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 40. N7-(2-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
N7-(4-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
7-(5-amino-2-methylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(cyanomethyl)-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
7-iodo-N-(3-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,. 7-(4-amino-3-nitrophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(2-methoxypyridin-3-yl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(7-iodothieno[3,2-d]pyrimidin-2-ylamino)phenyl)methanol,
N-tert-butyl-3-(2-(3-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be- nzenesulfonamide,
N-tert-butyl-3-(2-(3-(hydroxymethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-morpholinophenyl)-7-(4-nitrophenylthio)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(4-amino-3-nitrophenyl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine 53.
N-(3,4-dimethoxyphenyl)-7-(2-methoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4-dimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(2-aminopyrimidin-5-yl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, N-(3,4-dimethoxyphenyl)-7-(2,6-dimethoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-(2,4-dimethoxypyrimidin-5-yl)thieno[3,2-d]pyrimidin-2-amine,
7-iodo-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,.
2-cyano-N-(4-methyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,.
ethyl 3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzoate, 7-bromo-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,.
N-(3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(cyanomethyl)-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)benzamide,.
N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
tert-butyl-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-pyrazole-1-carboxylate,
7-bromo-N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-tert-butyl-3 -(2-(4-((4-ethylpiperazin-1-yl)methyl)phenylamino)thieno[3,- 2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(cyanomethyl)-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3 -(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]- pyrimidin-7-yl)benzenesulfonamide,
tert-butyl pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(3-chloro-4-fluorophenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl-)-1H-pyrazole-1-carboxylate,
7-(benzo[d][1,3]dioxol-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 5-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-ind-
ole-1-carboxylate, 7-(2-aminopyrimidin-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-5,6-di-hydropyridine-1(2H)-carboxylate,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-phenyl)acetamide,
N-(4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-(4-(4-methylpiperazin-1-yl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
N-(2-methoxy-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
7-bromo-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, (3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, N-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzyl)methanesulfonamide,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(4-(morpholinomethyl)phenyl)-7-(3-(piperazin-1-yl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(6-(2-morpholinoethylamino)pyridin-3-yl)-N-(3,4,5-trimethoxyphenyl)thie-no[3,2-d]pyrimidin-2-amine,
7-(2-ethylphenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-(aminomethyl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(4-(1-ethylpiperidin-4-yloxy)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,.
N-(2,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-bromo-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine,
and pharmaceutically acceptable salts and prodrugs thereof.
Clause 40. The method of Clause 39 or Clause 39, further comprising the coadministration
of
- a) at least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or
- b) at least one additional antiviral agent selected from the group consisting of non-nucleoside
reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion inhibitors,
entry inhibitors, attachment inhibitors, and integrase inhibitors.
Clause 41. The method of Clause 40, wherein the thymidine nucleoside antiretroviral
agent is zidovudine (AZT).
Clause 42. The method of Clause 40, wherein the thymidine nucleoside antiretroviral
agent is DAPD or APD.
Clause 43. The method of Clause 40, wherein the nucleoside antiretroviral agents comprise:
- a) (-)-FTC or 3TC,
- b) TDF,
- c) DAPD or APD,
- d) AZT, and
- e) a NNRTI, a protease inhibitor, or an integrase inhibitor.
Clause 44. The method of Clause 43, wherein the NNRTI is Sustiva, the protease inhibitor
is Kaletra, or the integrase inhibitor is Raltegravir or Elvitegravir.
Clause 45. The method of Clause 40, wherein the compound of Formula A or B, and the
at least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or at least one additional antiviral agent selected from the group consisting
of non-nucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion
inhibitors, entry inhibitors, attachment inhibitors, and integrase inhibitors, are
administered in combination.
Clause 46. The method of Clause 40, wherein the compound of Formula A or B, and the
at least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or at least one additional antiviral agent selected from the group consisting
of non-nucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion
inhibitors, entry inhibitors, attachment inhibitors, and integrase inhibitors, are
administered in alternation.
Clause 47. The method of Clause 38, wherein the compound of Formula A is

or a pharmaceutically acceptable salt or prodrug thereof.
Clause 48. The method of Clause 38, wherein the compound of Formula B is

or a pharmaceutically acceptable salt or prodrug thereof..
Clause 49. The method of any of Clauses 38-48, further comprising the coadministration
of a macrophage depleting agent.
Clause 50. A method of treating or eradicating an HIV infection, comprising:
- a) reducing viral loads in a patient by administering a combination of HAART and a
JAK inhibitor according to any of Clauses 38-48,
- b) systemically depleting macrophages with a macrophage depleting agent while maintaining
HAART and JAK inhibitor therapy until a sufficient amount of macrophages are depleted,
as determined, for example, by flow cytometry that a low level or no macrophages are
present in the circulating periphery upon blood draw,,
- c) withdrawing treatment with the macrophage depleting agent, while maintaining treatment
with HAART and the JAK inhibitor, where withdrawal of HAART and/or JAK inhibitor is
executed upon sustained low level or absent viremia, and
- d) either withdrawing HAART while JAK inhibitor therapy is maintained, or withdrawing
both HAART and JAK inhibitor therapy, optionally while monitoring viral rebound.
Clause 51. The method of Clause 50, wherein the macrophage depleting agent is Boniva
or Fosamax.
Clause 52. The method of Clause 50, wherein the JAK inhibitor is

or

or a pharmaceutically acceptable salt or prodrug thereof.
Clause 53. A method of treating or eradicating an HIV infection, comprising:
- a) reducing viral loads in a patient by administering a combination of HAART and a
JAK inhibitor according to any of Clauses 38-48,
- b) administering a reactivation agent, while maintaining one or both of HAART and
JAK inhibitor therapy,
- c) withdrawing treatment with the reactivation agent, upon assessment of increased
viral loads in the periphery that may be coupled with but not limited to assessment
of diminished or absent memory lymphocytes with flow cytometry, while continuing treatment
with HAART and one or more JAK inhibitors, until low level or absent viremia is maintained,
- d) withdrawing HAART, while JAK inhibitor therapy is maintained, or withdrawing both
HAART and JAK inhibitor therapy, optionally while monitoring viral rebound.
Clause 54. The method of Clause 53, wherein the reactivation agent is panobinostat.
Clause 55. The method of Clause 53, wherein the JAK inhibitor is

or

or a pharmaceutically acceptable salt or prodrug thereof.
Clause 56. A method of treating a viral disease in a patient in need of treatment
thereof, comprising administering an effective, antiviral amount of a JAK inhibitor
compound of Clause 38 or Clause 39 to a patient in need of treatment thereof.
Clause 57. The method of Clause 56, wherein the compound is administered in combination
or alternation with a second anti-viral agent optionally selected from the group consisting
of an interferon, a ribavirin, an interleukin, a NS3 protease inhibitor, a NS5A inhibitor,
a cysteine protease inhibitor, a phenanthrenequinone, a thiazolidine derivative, a
thiazolidine, a benzanilide, a helicase inhibitor, a polymerase inhibitor, a nucleotide
analogue, a gliotoxin, a cerulenin, an antisense phosphorothioate oligodeoxynucleotide,
an inhibitor of IRES-dependent translation, and a ribozyme.
Clause 58. The method of Clause 57, wherein the second agent is selected from the
group consisting of pegylated interferon alpha 2a, interferon alphacon-1, natural
interferon, albuferon, interferon beta- la, omega interferon, interferon alpha, interferon
gamma, interferon tau, interferon delta and interferon γ-lb.
Clause 59. The method of Clause 56, wherein the viral disease is caused by a virus
selected from the group consisting of an adenovirus, an Alphaviridae, an Arbovirus,
an Astro virus, a Bunyaviridae, a Coronaviridae, a Filoviridae, a Flaviviridae, a
Hepadnaviridae, a Herpesviridae (such as HSV-1, HSV-2, EBV, CMV), an Alphaherpesvirinae,
a Betaherpesvirinae, a Gammaherpesvirinae, a Norwalk Virus, an Astroviridae, a Caliciviridae,
an Orthomyxoviridae, a Paramyxoviridae, a Paramyxoviruses, a Rubulavirus, a Morbillivirus,
a Papovaviridae, a Parvoviridae, a Picornaviridae, an Aphthoviridae, a Cardioviridae,
an Enteroviridae, a Coxsackie virus, a Polio Virus, a Rhinoviridae, a Phycodnaviridae,
a Poxviridae, a Reoviridae, a Rotavirus, a Retroviridae, an A-Type Retrovirus, an
Immunodeficiency Virus, a Leukemia Viruses, an Avian Sarcoma Viruses, a Rhabdoviruses,
a Rubiviridae and a Togaviridae.
Clause 60. The method of Clause 56, wherein the viral disease is caused by a Flaviviridae
virus.
Clause 61. The method of Clause 56, wherein the viral disease is caused by a Dengue
virus or a Chikungunya virus.
Clause 62. The method of Clause 56, wherein the viral disease is caused by a BVDV
virus.
Clause 63. The method of Clause 56, wherein the viral disease is caused by a West
Nile virus.
Clause 64. The method of Clause 56, wherein the viral disease is caused by a hepatitis
B virus.
Clause 65. The method of Clause 56, wherein the viral disease is caused by a hepatitis
C virus.
Clause 66. The method of Clause 56, wherein the viral disease is the result of a co-infection
of a hepatitis C virus with HIV and/or HBV.
Clause 67. A method of treating or eradicating an HIV infection, comprising:
- a) reducing viral loads in a patient by administering a JAK inhibitor according to
any of Clauses 38-48, and
- b) administering an anti-HIV vaccine and/or an immunostimulatory agent before, during,
or after the JAK inhibitor is administered.
Clause 68. The method of Clause 67, further comprising administration of HAART along
with the JAK inhibitor.
Clause 69. The method of Clause 68. wherein the HAART comprises the coadministration
of
- a) at least one each of an adenine, cytosine, thymidine, and guanine nucleoside antiviral
agent, or
- b) at least one additional antiviral agent selected from the group consisting of non-nucleoside
reverse transcriptase inhibitors (NNRTI), protease inhibitors, fusion inhibitors,
entry inhibitors, attachment inhibitors, and integrase inhibitors.
Clause 70. The method of Clause 69, wherein the thymidine nucleoside antiretroviral
agent is zidovudine (AZT).
Clause 71. The method of Clause 69, wherein the thymidine nucleoside antiretroviral
agent is DAPD or APD.
Clause 72. The method of Clause 69, wherein the nucleoside antiretroviral agents comprise:
- a) (-)-FTC or 3TC,
- b) TDF,
- c) DAPD or APD,
- d) AZT, and
- e) a NNRTI, a protease inhibitor, or an integrase inhibitor.
Clause 73. The method of Clause 72, wherein the NNRTI is Sustiva, the protease inhibitor
is Kaletra, or the integrase inhibitor is Raltegravir or Elvitegravir.
Clause 74. The method of Clause 69, wherein the JAK inhibitor, HAART, and vaccine
or immunostimulatory compound are administered in combination.
Clause 75. The method of Clause 69, wherein the JAK inhibitor, HAART, and vaccine
or immunostimulatory compound are administered in alternation.
[0458] While the foregoing specification teaches the principles of the present invention,
with examples provided for the purpose of illustration, it will be understood that
the practice of the invention encompasses all of the usual variations, adaptations
and/or modifications as come within the scope of the following claims and their equivalents.
All references cited herein are incorporated by reference in their entirety for all
purposes.
1. An effective, antiviral amount of a compound for use in treating or preventing a viral
disease, wherein the viral disease is caused by a virus selected from the group consisting
of an adenovirus, an Alphaviridae, an Arbovirus, an Astro virus, a Bunyaviridae, a
Coronaviridae, a Filoviridae, a Flaviviridae, a Hepadnaviridae, a Herpesviridae (such
as HSV-1, HSV-2, EBV, CMV), an Alphaherpesvirinae, a Betaherpesvirinae, a Gammaherpesvirinae,
a Norwalk Virus, an Astroviridae, a Caliciviridae, an Orthomyxoviridae, a Paramyxoviridae,
a Paramyxoviruses, a Rubulavirus, a Morbillivirus, a Papovaviridae, a Parvoviridae,
a Picornaviridae, an Aphthoviridae, a Cardioviridae, an Enteroviridae, a Coxsackie
virus, a Polio Virus, a Rhinoviridae, a Phycodnaviridae, a Poxviridae, a Reoviridae,
a Rotavirus, a Retroviridae, an A-Type Retrovirus, an Immunodeficiency Virus, a Leukemia
Viruses, an Avian Sarcoma Viruses, a Rhabdoviruses, a Rubiviridae and a Togaviridae,
wherein the compound is a compound of Formula A:

wherein:
or the pharmaceutically acceptable salt thereof; wherein
R
1 is a group of the formula
wherein y is 0, 1 or 2;
R4 is selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C2-C6)alkenyl, (C2-C6)alkynyl wherein the alkyl, alkenyl and alkynyl groups are optionally substituted
by deuterium, hydroxy, amino, trifluoromethyl, (C1-C4)alkoxy, (C1-C6)acyloxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, nitro, (C2-C6)alkenyl, (C2-C6)alkynyl or (C1-C6)acylamino; or
R4 is (C3-C10)cycloalkyl wherein the cycloalkyl group is optionally substituted by deuterium, hydroxy,
amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R5 is (C2-C9)heterocycloalkyl wherein the heterocycloalkyl groups must be substituted by one to
five carboxy, cyano, amino, deuterium, hydroxy, (C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(Ci-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO-O--, R15R16N-CO-(C1-C6)alkyl, (C1-C6)alkyl-S(O)m, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl; or a group of the formula
wherein a is 0, 1, 2, 3 or 4;
b, c, e, f and g are each independently 0 or 1;
d is 0, 1, 2, or 3;
X is S(O)n wherein n is 0, 1 or 2; oxygen, carbonyl or --C(=N-cyano)-;
Y is S(O)n wherein n is 0, 1 or 2; or carbonyl; and
Z is carbonyl, C(O)O--, C(O)NR-- or S(O)n wherein n is 0, 1 or 2;
R6, R7, R8, R9, R10 and R11 are each independently selected from the group consisting of hydrogen or (C1-C6)alkyl optionally substituted by deuterium, hydroxy, amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R12 is carboxy, cyano, amino, oxo, deuterium, hydroxy, trifluoromethyl, (C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)zamino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO-( C1-C6)alkyl, R15C(O)NH, R15OC(O)NH, R15NHC(O)NH, (C1-C6)alkyl-S(O)m, (C1-C6)alkyl-S(O)m--( C1-C6)alkyl, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16N(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl;
R2 and R3 are each independently selected from the group consisting of hydrogen, deuterium,
amino, halo, hydroxy, nitro, carboxy, (C2-C6)alkenyl, (C2-C6)alkynyl, trifluoromethyl, trifluoromethoxy, (C1-C6)alkyl, (C1-C6)alkoxy, (C3-C10)cycloalkyl wherein the alkyl, alkoxy or cycloalkyl groups are optionally substituted
by one to three groups selected from halo, hydroxy, carboxy, amino (C1-C6)alkylthio, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl, (C3-C9)cycloalkyl or (C6-C10)aryl; or R2 and R3 are each independently (C3-C10)cycloalkyl, (C3-C10)cycloalkoxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C6-C10)arylamino, (C1-C6)alkylthio, (C6-C10)arylthio, (C1-C6)alkylsulfinyl, (C6-C10)arylsulfinyl, (C1-C6)alkylsulfonyl, (C6-C10)arylsulfonyl, (C1-C6)acyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkylamino-CO--, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl or (C6-C10)aryl wherein the heteroaryl, heterocycloalkyl and aryl groups are optionally substituted
by one to three halo, (C1-C6)alkyl, (C1-C6)alkyl-CO- -NH--, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--(C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, carboxy(C1-C6)alkoxy, benzyloxycarbonyl(C1-C6)alkoxy, (C1-C6)alkoxycarbonyl(C1-C6)alkoxy, (C6-C10)aryl, amino, amino(C1-C6)alkyl, (C1-C6)alkoxycarbonylamino, (C6-C10)aryl(C1-C6)alkoxycarbonylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C1-C6)alkylamino(C1-C6)alkyl, ((C1-C6)alkyl)2amino(C1-C6)alkyl, hydroxy, (C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, (C1-C6)alkoxycarbonyl, (C1-C6)alkoxycarbonyl(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH- -, (C1-C6)alkyl-CO--NH--, cyano, (C5-C9)heterocycloalkyl, amino-CO--NH--, (C1-C6)alkylamino-CO--NH--, ((C1-C6)alkyl)2amino-CO--NH--, (C6-C10)arylamino-CO-NH--, (C5-C9)heteroarylamino-CO--NH--, (C1-C6)alkylamino-CO--NH--( C1-C6)alkyl, ((C1-C6)alkyl)2amino-CO--NH--(C1-C6)alkyl, (C6-C10)arylamino-CO--NH-( C1-C6)alkyl, (C5-C9)heteroarylamino-CO--NH--( C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C6-Cio)arylsulfonyl, (C6-C10)arylsulfonylamino, (C6-C10)arylsulfonylamino(C1-C6)alkyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C5-C9)heteroaryl or (C2-C9)heterocycloalkyl.
or the compound is a compound of Formula B:

including pharmaceutically acceptable salt forms or prodrugs thereof, wherein:
A1 and A2 are independently selected from C and N;
T, U, and V are independently selected from O, S, N, CR5, and NR6;
wherein the 5-membered ring formed by A1, A2, U, T, and V is aromatic;
X is N or CR4;
Y is C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, (CR11R12)p--(C3-10 cycloalkylene)-(CR11R12 )q, (CR11R12)p-(arylene)-(CR11R12)q, (CR11R12)\p--(C1-10 heterocycloalkylene)-(CR11R12)q, (CR11R12)p-(heteroarylene)-(CR11R12)q, (CR11R12)pO(CR11R12)q, (CR11R12)pS(CR11R12)q, (CR11R12)pC(O)(CR11R12)q, (CR11R12)pC(O)NRc(CR11R12)q, (CR11R12)pC(O)O(CR11R12)q, (CR11R12)pOC(O)( CR11R12)q, (CR11R12)pOC(O)NRc(CR11R12)q, (CR11R12)pNRc(CR11R12)q, (CR11R12)pNRcC(O)NRd(CR11R12)q, (CR11R12)pS(O)(CR11R12)q, (CR11R12)pS(O)NRc(CR11R12)q, (CR11R12)pS(O)2(CR11R12)q, or (CR11R12)pS(O)2NRc(CR11R12)q, wherein said C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, cycloalkylene, arylene, heterocycloalkylene, or heteroarylene, is optionally
substituted with 1, 2, or 3 substituents independently selected from -D1-D2-D3-D4;
Z is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, =C--Ri, =N--Ri, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRCC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, N2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
wherein when Z is H, n is 1;
or the --(Y)n-Z moiety is taken together with i) A2 to which the moiety is attached, ii) R5 or R6 of either T or V, and iii) the C or N atom to which the R5 or R6 of either T or V is attached to form a 4- to 20-membered aryl, cycloalkyl, heteroaryl,
or heterocycloalkyl ring fused to the 5-membered ring formed by A1 A2, U, T, and V, wherein said 4- to 20-membered aryl, cycloalkyl, heteroaryl, or heterocycloalkyl
ring is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected
from-(W)m-Q;
W is C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, O, S, C(O), C(O)NRc', C(O)O, OC(O), OC(O)NRc', NRc', NRC'C(O)NRd', S(O), S(O)NRc', S(O)2, or S(O)2NRc';
Q is H, halo, CN, NO2, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl, wherein
said C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl is optionally substituted
with 1, 2, 3 or 4 substituents independently selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy2, CN, NO2, ORa', SRa', C(O)Rb', C(O)NRc'Rd', C(O)ORa, OC(O)Rb, OC(O)NRc'Rd', NRc'Rd', NRc'C(O)Rb', NRc'C(O)N Rc'Rd', N Rc'C(O)ORa', S(O)Rb', S(O)N Rc'Rd', S(O)2Rb', NRc'S(O)2Rb', and S(O)2N Rc'Rd';
Cy1 and Cy2 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl,
each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected
from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, CN, NO2, ORa", SRa", C(O)Rb", C(O)NRc''Rd", C(O)ORa", OC(O)Rb", OC(O)N Rc''Rd", NRc''Rd", NRc'C(O)Rb", NRc"C(O)ORa", NRc"S(O)Rb", NRc"S(O)2Rb", S(O)Rb", S(O)NRc"Rd", S(O)2Rb", and S(O)2NRc"Rd";
R1, R2, R3, and R4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NRcC(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, and S(O)2NR9R10;
R5 is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7, OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NR9C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, or S(O)2NR9R10;
R6 is H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, OR7, C(O)R8, C(O)NR9R10, C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, or S(O)2NR9R10;
R7 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R8 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R9 and R10 are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, C1-6 alkylcarbonyl, arylcarbonyl, C1-6 alkylsulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl,
heteroarylalkyl, cycloalkylalkyl and heterocycloalkylalkyl;
or R9 and R10 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group;
R11 and R12 are independently selected from H and -E1-E2-E3-E4;
D1 and E1 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D2 and E2 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, (C1-6 alkylene)r--O--(C1-6 alkylene)s, (C1-6 alkylene),--S--(C1-6 alkylene)s, (C1-6 alkylene)r--NRc--(C1-6 alkylene)s, (C1-6 alkylene)r- -CO--(C1-6 alkylene)s, (C1-6 alkylene)r--COO--(C1-6 alkylene)s, (C1-6 alkylene)r-CONRc-(C1-6 alkylene)s, (C1-6 alkylene)r--SO--(C1-6 alkylene)s, (C1-6 alkylene)r--SO2- -(C1-6 alkylene)s, (C1-6 alkylene)r--SONRc--(C1-6 alkylene)s, and (C1-6 alkylene)r-- NRcCONRf--(C1-6 alkylene)s, wherein each of the C1-6 alkylene, C2-6 alkenylene, and C2-6 alkynylene is optionally substituted by 1, 2 or 3 substituents independently selected
from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D3and E3 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
E4 and E4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRa, C(O)ORa, OC(O)RbOC(O)NRcRd NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
Ra is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-61-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ra' and Ra" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb' and Rb" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc and Rd are independently selected from H, Cy1, --(C1-6 alkyl)-Cy1, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl, is optionally substituted with 1, 2, or 3 substituents independently selected
from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
Rc' and Rd' are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
or Rc' and Rd' together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc" and Rd" are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, C1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;
or Rc" and Rd" together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ri is H, CN, NO2, or C1-6 alkyl;
Re and Rf are independently selected from H and C1-6 alkyl;
Ri is H, CN, or NO2;
m is 0 or 1;
n is 0 or 1;
p is 0, 1, 2, 3, 4, 5, or 6;
q is 0, 1, 2, 3, 4, 5 or 6;
r is 0 or 1; and
s is 0 or 1.
2. An effective antiviral amount of a compound for use in treating or preventing a viral
disease, wherein the viral disease is caused by a virus selected from the group consisting
of an adenovirus, an Alphaviridae, an Arbovirus, an Astro virus, a Bunyaviridae, a
Coronaviridae, a Filoviridae, a Flaviviridae, a Hepadnaviridae, a Herpesviridae (such
as HSV-1, HSV-2, EBV, CMV), an Alphaherpesvirinae, a Betaherpesvirinae, a Gammaherpesvirinae,
a Norwalk Virus, an Astroviridae, a Caliciviridae, an Orthomyxoviridae, a Paramyxoviridae,
a Paramyxoviruses, a Rubulavirus, a Morbillivirus, a Papovaviridae, a Parvoviridae,
a Picornaviridae, an Aphthoviridae, a Cardioviridae, an Enteroviridae, a Coxsackie
virus, a Polio Virus, a Rhinoviridae, a Phycodnaviridae, a Poxviridae, a Reoviridae,
a Rotavirus, a Retroviridae, an A-Type Retrovirus, an Immunodeficiency Virus, a Leukemia
Viruses, an Avian Sarcoma Viruses, a Rhabdoviruses, a Rubiviridae and a Togaviridae,
and
wherein the compound is a JAK inhibitor selected from the group consisting of CEP-701
(Lestaurtinib), AZD1480, LY3009104/INCB28050 Pacritinib/SB1518, VX-509, GLPG0634,
INC424, R-348, CYT387, TG 10138, AEG 3482, 7-iodo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acryl
amide, 7-(3-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2amine, N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phen-
yl)acrylamide, N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, methyl 2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxylate,
N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(4-amino-3-methoxyphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide, N,N-dimethyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
1-ethyl-3-(2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)urea,
N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide,
2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)pheno- 1, 2-cyano-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)phenyl)acetamide,
N-(cyanomethyl)-2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxamide,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
1-ethyl-3-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)-2-(-trifluoromethoxy)phenyl)urea
20. N-(3-nitrophenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-iodo-N-(3-nitrophenyl)thieno[3,2-d]pyrimidin-2-amine,
N1-(7-(2-ethylphenyl)thieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be-
nzenesulfonamide, N1-(7-iodothieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, 7-(4-amino-3-(tri
fluoromethoxy)phenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, 7-(2-ethylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl-)acetamide, N-(cyanomethyl)-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(cyanomethyl)-N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(3-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-l)phenyl)methanesulfonamide,
4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide,
N-(4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-iodo-N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(2-isopropylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-bromo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 40. N7-(2-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
N7-(4-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
7-(5-amino-2-methylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(cyanomethyl)-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
7-iodo-N-(3-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,. 7-(4-amino-3-nitrophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(2-methoxypyridin-3-yl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(7-iodothieno[3,2-d]pyrimidin-2-ylamino)phenyl)methanol,
N-tert-butyl-3-(2-(3-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be- nzenesulfonamide,
N-tert-butyl-3-(2-(3-(hydroxymethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-morpholinophenyl)-7-(4-nitrophenylthio)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(4-amino-3-nitrophenyl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine 53.
N-(3,4-dimethoxyphenyl)-7-(2-methoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4-dimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(2-aminopyrimidin-5-yl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, N-(3,4-dimethoxyphenyl)-7-(2,6-dimethoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-(2,4-dimethoxypyrimidin-5-yl)thieno[3,2-d]pyrimidin-2-amine,
7-iodo-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,.
2-cyano-N-(4-methyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,.
ethyl 3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzoate, 7-bromo-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,.
N-(3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(cyanomethyl)-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)benzamide,.
N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
tert-butyl-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-pyrazole-1-carboxylate,
7-bromo-N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-tert-butyl-3 -(2-(4-((4-ethylpiperazin-1-yl)methyl)phenylamino)thieno[3,- 2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(cyanomethyl)-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3 -(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]- pyrimidin-7-yl)benzenesulfonamide,
tert-butyl pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(3-chloro-4-fluorophenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl-)-1H-pyrazole-1-carboxylate,
7-(benzo[d][1,3]dioxol-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 5-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-ind-
ole-1-carboxylate, 7-(2-aminopyrimidin-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-5,6-di-hydropyridine-1(2H)-carboxylate,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-phenyl)acetamide,
N-(4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-(4-(4-methylpiperazin-1-yl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
N-(2-methoxy-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
7-bromo-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, (3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, N-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzyl)methanesulfonamide,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(4-(morpholinomethyl)phenyl)-7-(3-(piperazin-1-yl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(6-(2-morpholinoethylamino)pyridin-3-yl)-N-(3,4,5-trimethoxyphenyl)thie-no[3,2-d]pyrimidin-2-amine,
7-(2-ethylphenyl)-N-(4-(2-(pyrrolidin-1 - yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-(aminomethyl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(4-(1-ethylpiperidin-4-yloxy)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(2,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-bromo-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine,
and pharmaceutically acceptable salts and prodrugs thereof.
3. The compound for use of Claim 1, wherein the compound of Formula A is

or a pharmaceutically acceptable salt or prodrug thereof..
4. The compound for use of Claim 2, wherein the JAK inhibitor is LY3009104/INCB28050.
5. The compound for use of any of Claims 1-4, wherein the virus is Coronaviridae.
6. An effective amount of a compound for use in treating or preventing an AIDS-related
neurological disorder, AIDS-related complex (ARC), persistent generalized lymphadenopathy
(PGL), anti-HIV antibody positive and HIV-positive conditions, Kaposi's sarcoma, thrombocytopenia
purpurea or HIV-1-related opportunistic infections;
wherein the compound is a compound of Formula A:

wherein:
or the pharmaceutically acceptable salt thereof; wherein
R
1 is a group of the formula

wherein y is 0, 1 or 2;
R4 is selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C2-C6)alkenyl, (C2-C6)alkynyl wherein the alkyl, alkenyl and alkynyl groups are optionally substituted
by deuterium, hydroxy, amino, trifluoromethyl, (C1-C4)alkoxy, (C1-C6)acyloxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, nitro, (C2-C6)alkenyl, (C2-C6)alkynyl or (C1-C6)acylamino; or
R4 is (C3-C10)cycloalkyl wherein the cycloalkyl group is optionally substituted by deuterium, hydroxy,
amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R5 is (C2-C9)heterocycloalkyl wherein the heterocycloalkyl groups must be substituted by one to
five carboxy, cyano, amino, deuterium, hydroxy, (C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, amino(C1-C6)alkyl, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO--( C1-C6)alkyl, (C1-C6)alkyl-S(O)m, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl; or a group of the formula
wherein a is 0, 1, 2, 3 or 4;
b, c, e, f and g are each independently 0 or 1;
d is 0, 1, 2, or 3;
X is S(O)n wherein n is 0, 1 or 2; oxygen, carbonyl or --C(=N-cyano)-;
Y is S(O)n wherein n is 0, 1 or 2; or carbonyl; and
Z is carbonyl, C(O)O--, C(O)NR-- or S(O)n wherein n is 0, 1 or 2;
R6, R7, R8, R9, R10 and R11 are each independently selected from the group consisting of hydrogen or (C1-C6)alkyl optionally substituted by deuterium, hydroxy, amino, trifluoromethyl, (C1-C6)acyloxy, (C1-C6)acylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, cyano, cyano(C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, nitro, nitro(C1-C6)alkyl or (C1-C6)acylamino;
R12 is carboxy, cyano, amino, oxo, deuterium, hydroxy, trifluoromethyl, (C1-C6)alkyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)alkoxy, halo, (C1-C6)acyl, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, amino(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH, (C1-C6)alkylamino-CO--, (C2-C6)alkenyl, (C2-C6) alkynyl, (C1-C6)alkylamino, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, (C1-C6)acyloxy(C1-C6)alkyl, nitro, cyano(C1-C6)alkyl, halo(C1-C6)alkyl, nitro(C1-C6)alkyl, trifluoromethyl, trifluoromethyl(C1-C6)alkyl, (C1-C6)acylamino, (C1-C6)acylamino(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)acylamino, amino(C1-C6)acyl, amino(C1-C6)acyl(C1-C6)alkyl, (C1-C6)alkylamino(C1-C6)acyl, ((C1-C6)alkyl)2amino(C1-C6)acyl, R15R16N--CO--O--, R15R16N--CO--( C1-C6)alkyl, R15C(O)NH, R15OC(O)NH, R15NHC(O)NH, (C1-C6)alkyl-S(O)m, (C1-C6)alkyl-S(O)m--( C1-C6)alkyl, R15R16NS(O)m, R15R16NS(O)m(C1-C6)alkyl, R15S(O)mR16N, R15S(O)mR16N(C1-C6)alkyl wherein m is 0, 1 or 2 and R15 and R16 are each independently selected from hydrogen or (C1-C6)alkyl;
R2 and R3 are each independently selected from the group consisting of hydrogen, deuterium,
amino, halo, hydroxy, nitro, carboxy, (C2-C6)alkenyl, (C2-C6)alkynyl, trifluoromethyl, trifluoromethoxy, (C1-C6)alkyl, (C1-C6)alkoxy, (C3-C10)cycloalkyl wherein the alkyl, alkoxy or cycloalkyl groups are optionally substituted
by one to three groups selected from halo, hydroxy, carboxy, amino (C1-C6)alkylthio, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl, (C3-C9)cycloalkyl or (C6-C10)aryl; or R2 and R3 are each independently (C3-C10)cycloalkyl, (C3-C10)cycloalkoxy, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C6-C10)arylamino, (C1-C6)alkylthio, (C6-C10)arylthio, (C1-C6)alkylsulfinyl, (C6-C10)arylsulfinyl, (C1-C6)alkylsulfonyl, (C6-C10)arylsulfonyl, (C1-C6)acyl, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkylamino-CO--, (C5-C9)heteroaryl, (C2-C9)heterocycloalkyl or (C6-C10)aryl wherein the heteroaryl, heterocycloalkyl and aryl groups are optionally substituted
by one to three halo, (C1-C6)alkyl, (C1-C6)alkyl-CO--NH--, (C1-C6)alkoxy-CO--NH--, (C1-C6)alkyl-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--( C1-C6)alkyl, (C1-C6)alkoxy-CO--NH--( C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, carboxy(C1-C6)alkoxy, benzyloxycarbonyl(C1-C6)alkoxy, (C1-C6)alkoxycarbonyl(C1-C6)alkoxy, (C6-C10)aryl, amino, amino(C1-C6)alkyl, (C1-C6)alkoxycarbonylamino, (C6-C10)aryl(C1-C6)alkoxycarbonylamino, (C1-C6)alkylamino, ((C1-C6)alkyl)2amino, (C1-C6)alkylamino(C1-C6)alkyl, ((C1-C6)alkyl)2amino(C1-C6)alkyl, hydroxy, (C1-C6)alkoxy, carboxy, carboxy(C1-C6)alkyl, (C1-C6)alkoxycarbonyl, (C1-C6)alkoxycarbonyl(C1-C6)alkyl, (C1-C6)alkoxy-CO--NH- -, (C1-C6)alkyl-CO--NH--, cyano, (C5-C9)heterocycloalkyl, amino-CO--NH--, (C1-C6)alkylamino-CO--NH--, ((C1-C6)alkyl)zamino-CO--NH--, (C6-C10)arylamino-CO-NH--, (C5-C9)heteroarylamino-CO--NH--, (C1-C6)alkylamino-CO--NH--(C1-C6)alkyl, ((C1-C6)alkyl)2amino-CO--NH--( C1-C6)alkyl, (C6-C10)arylamino-CO--NH-(C1-C6)alkyl, (C5-C9)heteroarylamino-CO--NH--(C1-C6)alkyl, (C1-C6)alkylsulfonyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C6-C10)arylsulfonyl, (C6-C10)arylsulfonylamino, (C6-C10)arylsulfonylamino(C1-C6)alkyl, (C1-C6)alkylsulfonylamino, (C1-C6)alkylsulfonylamino(C1-C6)alkyl, (C5-C9)heteroaryl or (C2-C9)heterocycloalkyl.
or the compound is a compound of Formula B:

including pharmaceutically acceptable salt forms or prodrugs thereof, wherein:
A1 and A2 are independently selected from C and N;
T, U, and V are independently selected from O, S, N, CR5, and NR6;
wherein the 5-membered ring formed by A1, A2, U, T, and V is aromatic;
X is N or CR4;
Y is C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, (CR11R12)p--(C3-10 cycloalkylene)-(CR11R12)q, (CR11R12)p-(arylene)-(CR11R12)q, (CR11R12)\p--(C1-10 heterocycloalkylene)-(CR11R12)q, (CR11R12)p-(heteroarylene)-(CR11R12)q, (CR11R12)pO(CR11R12)q, (CR11R12)pS(CR11R12)q, (CR11R12)pC(O)(CR11R12)q, (CR11R12)pC(O)NRc(CR11R12)q, (CR11R12)pC(O)O(CR11R12)q, (CR11R12)pOC(O)( CR11R12)q, (CR11R12)pOC(O)NRc(CR11R12)q, (CR11R12)pNRc(CR11R12)q, (CR11R12)pNRcC(O)NRd(CR11R12)q, (CR11R12)pS(O)(CR11R12)q, (CR11R12)pS(O)NRc(CR11R12)q, (CR11R12)pS(O)2(CR11R12)q, or (CR11R12)pS(O)2NRc(CR11R12)q, wherein said C1-8 alkylene, C2-8 alkenylene, C2-8 alkynylene, cycloalkylene, arylene, heterocycloalkylene, or heteroarylene, is optionally
substituted with 1, 2, or 3 substituents independently selected from -D1-D2-D3-D4;
Z is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, =C--Ri, =N--Ri, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, N2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
wherein when Z is H, n is 1;
or the --(Y)n-Z moiety is taken together with i) A2 to which the moiety is attached, ii) R5 or R6 of either T or V, and iii) the C or N atom to which the R5 or R6 of either T or V is attached to form a 4- to 20-membered aryl, cycloalkyl, heteroaryl,
or heterocycloalkyl ring fused to the 5-membered ring formed by A1 A2, U, T, and V, wherein said 4- to 20-membered aryl, cycloalkyl, heteroaryl, or heterocycloalkyl
ring is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected
from-(W)m-Q;
W is C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, O, S, C(O), C(O)NRc', C(O)O, OC(O), OC(O)NRc', NRc', NRc'C(O)NRd', S(O), S(O)NRc', S(O)2, or S(O)2NRc';
Q is H, halo, CN, NO2, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl, wherein
said C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl, C1-8 haloalkyl, aryl, cycloalkyl, heteroaryl, or heterocycloalkyl is optionally substituted
with 1, 2, 3 or 4 substituents independently selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy2, CN, NO2, ORa', SRa', C(O)Rb', C(O)NRc'Rd', C(O)ORa', OC(O)Rb', OC(O)NRc'Rd', NRc'Rd', NRc'C(O)Rb', NRc'C(O)N Rc'Rd', N Rc'C(O)ORa', S(O)Rb', S(O)N Rc'Rd', S(O)2Rb', NRc'S(O)2Rb', and S(O)2N Rc'Rd';
Cy1 and Cy2 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl,
each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected
from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, CN, NO2, ORa", SRa", C(O)Rb", C(O)NRc''Rd", C(O)ORa", OC(O)Rb", OC(O)N Rc''Rd", NRc''Rd", NRc''C(O)Rb", NRc"C(O)ORa", NRc"S(O)Rb", NRc"S(O)2Rb", S(O)Rb", S(O)NRc"Rd", S(O)2Rb", and S(O)2NRc"Rd";
R1, R2, R3, and R4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NRcC(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, and S(O)2NR9R10;
R5 is H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, CN, NO2, OR7, SR7, C(O)R8, C(O)NR9R10, C(O)OR7, OC(O)R8, OC(O)NR9R10, NR9R10, NR9C(O)R8, NR9C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, NR9S(O)2R8, or S(O)2NR9R10;
R6 is H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, OR7, C(O)R8, C(O)NR9R10, C(O)OR7, S(O)R8, S(O)NR9R10, S(O)2R8, or S(O)2NR9R10;
R7 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R8 is H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl;
R9 and R10 are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, C1-6 alkylcarbonyl, arylcarbonyl, C1-6 alkylsulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl,
heteroarylalkyl, cycloalkylalkyl and heterocycloalkylalkyl;
or R9 and R10 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group;
R11 and R12 are independently selected from H and -E1-E2-E3-E4;
D1 and E1 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D2 and E2 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, (C1-6 alkylene)r--O--(C1-6 alkylene)s, (C1-6 alkylene)r--S--(C1-6 alkylene)s, (C1-6 alkylene)r--NRc--(C1-6 alkylene)s, (C1-6 alkylene)r--CO--(C1-6 alkylene)s, (C1-6 alkylene)r--COO--(C1-6 alkylene)s, (C1-6 alkylene)r-CONRc--(C1-6 alkylene)s, (C1-6 alkylene)r--SO--(C1-6 alkylene)s, (C1-6 alkylene)r--SO2--(C1-6 alkylene)s, (C1-6 alkylene)r--SONRc--(C1-6 alkylene)s, and (C1-6 alkylene)r-NRcCONRf--(C1-6 alkylene)s, wherein each of the C1-6 alkylene, C2-6 alkenylene, and C2-6 alkynylene is optionally substituted by 1, 2 or 3 substituents independently selected
from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
D3and E3 are independently absent or independently selected from C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene, wherein
each of the C1-6 alkylene, C2-6 alkenylene, C2-6 alkynylene, arylene, cycloalkylene, heteroarylene, and heterocycloalkylene is optionally
substituted by 1, 2 or 3 substituents independently selected from halo, CN, NO2, N3, SCN, OH, C1-6 alkyl, C1-6 haloalkyl, C2-8 alkoxyalkyl, C1-6 alkoxy, C1-6 haloalkoxy, amino, C1-6 alkylamino, and C2-8 dialkylamino;
E4 and E4 are independently selected from H, halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRa, C(O)ORa, OC(O)RbOC(O)NRcRd NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl)Rb, and S(O)2NRcRd, wherein said C1-8 alkyl, C2-8 alkenyl, or C2-8 alkynyl, is optionally substituted with 1, 2, 3, 4, 5, or 6 substituents independently
selected from halo, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 haloalkyl, halosulfanyl, C1-4 hydroxyalkyl, C1-4 cyanoalkyl, Cy1, CN, NO2, ORa, SRa, C(O)Rb, C(O)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(O)Rb, NRcC(O)NRcRd, NRcC(O)ORa, C(=NRi)NRcRd, NRcC(=NRi)NRcRd, S(O)Rb, S(O)NRcRd, S(O)2Rb, NRcS(O)2Rb, C(=NOH)Rb, C(=NO(C1-6 alkyl))Rb, and S(O)2NRcRd;
Ra is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb is H, Cy1, --(C1-6 alkyl)-Cy1, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-6 alkyl, C1-61-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected
from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ra' and Ra" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rb' and Rb" are independently selected from H, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc and Rd are independently selected from H, Cy1, --(C1-6 alkyl)-Cy1, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, or C2-6 alkynyl, is optionally substituted with 1, 2, or 3 substituents independently selected
from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from Cy1, --(C1-6 alkyl)-Cy1, OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, and halosulfanyl;
Rc' and Rd' are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
or Rc'and Rd' together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Rc" and Rd" are independently selected from H, C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl and heterocycloalkylalkyl, wherein said C1-10 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl,
cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3
substituents independently selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, halosulfanyl, C1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;
or Rc" and Rd" together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered
heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently
selected from OH, CN, amino, halo, C1-6 alkyl, C1-6 haloalkyl, C1-6 haloalkyl, halosulfanyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl
and heterocycloalkyl;
Ri is H, CN, NO2, or C1-6 alkyl;
Re and Rf are independently selected from H and C1-6 alkyl;
Ri is H, CN, or NO2;
m is 0 or 1;
n is 0 or 1;
p is 0, 1, 2, 3, 4, 5, or 6;
q is 0, 1, 2, 3, 4, 5 or 6;
r is 0 or 1; and
s is 0 or 1,
in the preparation of a medicament for use in treating or preventing an HIV infection.
7. An effective antiviral amount of a compound for use in treating or preventing an AIDS-related
neurological disorder, AIDS-related complex (ARC), persistent generalized lymphadenopathy
(PGL), anti-HIV antibody positive and HIV-positive conditions, Kaposi's sarcoma, thrombocytopenia
purpurea or HIV-1-related opportunistic infections;
wherein the compound is a JAK inhibitor selected from the group consisting of CEP-701
(Lestaurtinib), AZD1480, LY3009104/INCB28050 Pacritinib/SB1518, VX-509, GLPG0634,
INC424, R-348, CYT387, TG 10138, AEG 3482, 7-iodo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acryl
amide, 7-(3-aminophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2amine, N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phen-
yl)acrylamide, N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, methyl 2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxylate,
N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(4-amino-3-methoxyphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide, N,N-dimethyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
1-ethyl-3-(2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)urea,
N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)metha- nesulfonamide,
2-methoxy-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)pheno- 1, 2-cyano-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)phenyl)acetamide,
N-(cyanomethyl)-2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidine-7-carboxamide,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
1-ethyl-3-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)-2-(-trifluoromethoxy)phenyl)urea
20. N-(3-nitrophenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-iodo-N-(3-nitrophenyl)thieno[3,2-d]pyrimidin-2-amine,
N1-(7-(2-ethylphenyl)thieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be-
nzenesulfonamide, N1-(7-iodothieno[3,2-d]pyrimidin-2-yl)benzene-1,3-diamine, 7-(4-amino-3-(tri
fluoromethoxy)phenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, 7-(2-ethylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl-)acetamide, N-(cyanomethyl)-N-(3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(cyanomethyl)-N-(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
N-(3-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-y-l)phenyl)methanesulfonamide,
4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)b- enzenesulfonamide,
N-(4-(5-methyl-2-(4-morpholinophenylamino)-5H-pyrrolo[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-iodo-N-(4-morpholinophenyl)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, 7-(2-isopropylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-bromo-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine 40. N7-(2-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
N7-(4-isopropylphenyl)-N2-(4-morpholinophenyl)thieno[3,2-d]pyrimidine-2,7-diamine,
7-(5-amino-2-methylphenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, N-(cyanomethyl)-4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
7-iodo-N-(3-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,. 7-(4-amino-3-nitrophenyl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(2-methoxypyridin-3-yl)-N-(4-morpholinophenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(7-iodothieno[3,2-d]pyrimidin-2-ylamino)phenyl)methanol,
N-tert-butyl-3-(2-(3-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)be- nzenesulfonamide,
N-tert-butyl-3-(2-(3-(hydroxymethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-morpholinophenyl)-7-(4-nitrophenylthio)-5H-pyrrolo[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(4-amino-3-nitrophenyl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine 53.
N-(3,4-dimethoxyphenyl)-7-(2-methoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(3,4-dimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(2-aminopyrimidin-5-yl)-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, N-(3,4-dimethoxyphenyl)-7-(2,6-dimethoxypyridin-3-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-(2,4-dimethoxypyrimidin-5-yl)thieno[3,2-d]pyrimidin-2-amine,
7-iodo-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine, N-tert-butyl-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,.
2-cyano-N-(4-methyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,.
ethyl 3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)benzoate, 7-bromo-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,.
N-(3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(cyanomethyl)-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)benzamide,.
N-tert-butyl-3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl-)benzamide,
N-tert-butyl-3-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
tert-butyl-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-pyrazole-1-carboxylate,
7-bromo-N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-tert-butyl-3 -(2-(4-((4-ethylpiperazin-1-yl)methyl)phenylamino)thieno[3,- 2-d]pyrimidin-7-yl)benzenesulfonamide,
N-(4-((4-ethylpiperazin-1-yl)methyl)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,
N-(cyanomethyl)-3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzamide,
N-tert-butyl-3 -(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]- pyrimidin-7-yl)benzenesulfonamide,
tert-butyl pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
3-(2-(4-(2-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzenesulfonamide,
7-(3-chloro-4-fluorophenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(1-ethylpiperidin-4-yloxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl-)-1H-pyrazole-1-carboxylate,
7-(benzo[d][1,3]dioxol-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 5-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-1H-ind-
ole-1-carboxylate, 7-(2-aminopyrimidin-5-yl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
tert-butyl 4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-5,6-di-hydropyridine-1(2H)-carboxylate,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)-phenyl)acetamide,
N-(4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
N-(3-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanesulfonamide,
7-(4-(4-methylpiperazin-1-yl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno- [3,2-d]pyrimidin-2-amine,
N-(2-methoxy-4-(2-(4-(morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)acetamide,
7-bromo-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine, (3-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(3,4,5-trimethoxyphenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, (3-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol,
(4-(2-(4-morpholinophenylamino)thieno[3,2-d]pyrimidin-7-yl)phenyl)methanol, N-(pyrrolidin-1-yl)ethoxy)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzyl)methanesulfonamide,
tert-butyl morpholinomethyl)phenylamino)thieno[3,2-d]pyrimidin-7-yl)benzylcarbamate,
N-(4-(morpholinomethyl)phenyl)-7-(3-(piperazin-1-yl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(6-(2-morpholinoethylamino)pyridin-3-yl)-N-(3,4,5-trimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(2-ethylphenyl)-N-(4-(2-(pyrrolidin-1-yl)ethoxy)phenyl)thieno[3,2-d]pyrimidin-2-amine,
7-(4-(aminomethyl)phenyl)-N-(4-(morpholinomethyl)phenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(4-(1-ethylpiperidin-4-yloxy)phenyl)-7-(1H-pyrazol-4-yl)thieno[3,2-d]pyrimidin-2-amine,.
N-(2,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine, 7-bromo-N-(3,4-dimethoxyphenyl)thieno[3,2-d]pyrimidin-2-amine,
N-(3,4-dimethoxyphenyl)-7-phenylthieno[3,2-d]pyrimidin-2-amine,
and pharmaceutically acceptable salts and prodrugs thereof.
8. The compound for use of Claim 6, wherein the compound of Formula A is

or

or a pharmaceutically acceptable salt or prodrug thereof..
9. The compound for use of Claim 7, wherein the compound is LY3009104/INCB28050.
10. The compound for use of any one of Claims 6 to 9, wherein the compound is for the
treatment or prevention of AIDS-related neurological disorders.